Thrombocytopenia in<i>Plasmodium vivax</i>Malaria: How Significant?

Muley, Arti; Lakhani, Jitendra D.; Bhirud, Saurabh; Patel, Abhinam

doi:10.1155/2014/567469

Cited by 16 publications

(10 citation statements)

References 18 publications

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“…Although it has long been perceived that only Pf infections cause severe thrombocytopenia, recent studies suggest that this clinical condition is also common in P. vivax (Pv) and P. knowlesi (Pk) infections [15–20]. Thrombocytopenia is also considered as a sensitive diagnostic marker for malaria [21].…”

Section: Introductionmentioning

confidence: 99%

Association between Inflammatory Cytokine Levels and Thrombocytopenia duringPlasmodium falciparumandP. vivaxInfections in South-Western Coastal Region of India

Punnath

Dayanand

Chandrashekar

et al. 2019

Malaria Research and Treatment

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Background. Thrombocytopenia is a most commonly observed complication during malaria infections. Inflammatory cytokines such as IL-1, IL-6, and IL-10 have been documented in malaria induced thrombocytopaenia. This study was aimed to understand the possible relationship between inflammatory cytokines across varying degrees of thrombocytopenia duringP. vivax,P. falciparum,and mixed infections.Methods. A hospital-based cross sectional study was conducted at District Wenlock Hospital in Mangaluru, a city situated along the south-western coastal region of Arabian Sea in India. In this study, blood samples from 627 malaria patients were analyzed for infected parasite species, clinical conditions, platelet levels, and key cytokines that are produced in response to infection; samples from 176 uninfected healthy individuals were used as controls.Results. The results of our study showed a high prevalence of malarial thrombocytopenia (platelets <150 ×103/μl) in this endemic settings. About 62.7% patients had mild-to-moderate levels of thrombocytopenia and 16% patients had severe thrombocytopenia (platelets <50 × 103/μl). Upon comparison of cytokines across varying degrees of thrombocytopenia, irrespective of infecting species, the levels of TNF-αand IL-10 were significantly higher during thrombocytopenia, whereas IL-6 levels were considerably lower in severe thrombocytopenia patients suffering fromP. vivaxorP. falciparuminfections. The severe clinical complications observed in patients with malarial thrombocytopenia included severe anemia (17.5%), acute renal failure (12.7%), jaundice (27.0%), metabolic acidosis (36.5%), spontaneous bleeding (3.2%), hypoglycemia (25.4%), hyperparasitemia (4.8%), acute respiratory distress syndrome (1.6%), pulmonary edema (19.0%), and cerebral malaria (1.6%) in various combinations.Conclusion. Overall, the results of our study suggest that inflammatory cytokines influence the transformation of mild forms of thrombocytopenia into severe forms during malarial infections. Further studies are needed to understand the association of inflammatory cytokine responses with severe malaria complications and thrombocytopenia.

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Section: Introductionmentioning

confidence: 99%

Association between Inflammatory Cytokine Levels and Thrombocytopenia duringPlasmodium falciparumandP. vivaxInfections in South-Western Coastal Region of India

Punnath

Dayanand

Chandrashekar

et al. 2019

Malaria Research and Treatment

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“…Thrombocytopenia in malaria. Thrombocytopenia is a common feature in malaria [90,91]. In fact it is considered to be diagnostic in suspect febrile patients [92,93].…”

Section: Malariamentioning

confidence: 99%

Platelet interactions with viruses and parasites

Alonso

Cox

2015

Platelets

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“…A few studies have now shown that thrombocytopenia (platelet count in blood less than 1,50,000/μL) which was earlier seen in association with P. falciparum malaria is also seen in P. vivax malaria. [ 8 ] While some studies claim that thrombocytopenia should be viewed as a complication of severe malaria,[ 9 ] other studies are in disagreement to this aspect. [ 10 ] The manifestations of severe malaria are also showing a changing trend in the past decade.…”

Section: Introductionmentioning

confidence: 99%

Thrombocytopenia in malaria patients from an arid region of Western Rajasthan (India)

et al. 2020

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Context: The arid climate of Western Rajasthan is challenging for malaria transmission, with the number of cases correlating directly with the annual rainfall pattern. Moreover, >90% of the cases in this region are caused by Plasmodium vivax , which has recently been shown to cause a similar degree of thrombocytopenia as Plasmodium falciparum . Aims and Objectives: The aim of the study was to determine the degree of thrombocytopenia in malaria patients and its association with different species of malaria in this region with an unstable malaria epidemiology. Materials and Methods: This retrospective study was conducted on all microbiologically confirmed malaria patients with documented platelet counts from August 2017 to October 2018. Microbiological diagnosis was established by rapid diagnostic tests and peripheral blood film examination. Platelet counts were used to assess the degree of thrombocytopenia. Results: A total of 130 cases were included in the study, of which 118 (91%) were caused by P. vivax, while the rest 12 (9%) were caused by P. falciparum . Thrombocytopenia was present in 108 (83%) cases, and the mean values of platelets in thrombocytopenic patients with P. vivax and P. falciparum infection were 72600/μL and 48500/μL, respectively. Although P. falciparum infection was significantly associated with severe thrombocytopenia (odds ratio: 4.7, [95% confidence interval 1.3–16.1]), extremely low platelet counts ( n = 5) warranting platelet transfusions ( n = 1) were seen only in P. vivax cases. Only one patient required platelet transfusions in these patients suggesting good tolerance to thrombocytopenia. Conclusions: Avoiding unnecessary transfusions in febrile thrombocytopenic patients with an established malaria diagnosis can help in reducing transfusion-transmitted infections.

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Thrombocytopenia inPlasmodium vivaxMalaria: How Significant?

Cited by 16 publications

References 18 publications

Association between Inflammatory Cytokine Levels and Thrombocytopenia duringPlasmodium falciparumandP. vivaxInfections in South-Western Coastal Region of India

Association between Inflammatory Cytokine Levels and Thrombocytopenia duringPlasmodium falciparumandP. vivaxInfections in South-Western Coastal Region of India

Platelet interactions with viruses and parasites

Thrombocytopenia in malaria patients from an arid region of Western Rajasthan (India)

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