Dynamic alteration in splenic function during acute falciparum malaria
Plasmodium-infected erythrocytes lose their normal deformability and become susceptible to splenic filtration. In animal models, this is one mechanism of antimalarial defense. To assess the effect of acute falciparum malaria on splenic filtration, we measured the clearance of heated /sup 51/Cr-labeled autologous erythrocytes in 25 patients with acute falciparum malaria and in 10 uninfected controls. Two groups of patients could be distinguished. Sixteen patients had splenomegaly, markedly accelerated clearance of the labeled erythrocytes (clearance half-time, 8.4 +/- 4.4 minutes (mean +/- SD) vs. 62.5 +/- 36.5 minutes in controls; P less than 0.001), and a lower mean hematocrit than did the patients without splenomegaly (P less than 0.001). In the nine patients without splenomegaly, clearance was normal. After institution of antimalarial chemotherapy, however, the clearance in this group accelerated to supernormal rates similar to those in the patients with splenomegaly, but without the development of detectable splenomegaly. Clearance was not significantly altered by treatment in the group with splenomegaly. Six weeks later, normal clearance rates were reestablished in most patients in both groups. We conclude that splenic clearance of labeled erythrocytes is enhanced in patients with malaria if splenomegaly is present and is enhanced only after treatment if splenomegaly is absent. Whether this enhanced splenic function applies to parasite-infected erythrocytes in patients with malaria and has any clinical benefit will require further studies.
- Research Organization:
- Mahidol Univ., Bangkok, Thailand
- OSTI ID:
- 6244074
- Journal Information:
- N.Engl. J. Med.; (United States), Vol. 317:11
- Country of Publication:
- United States
- Language:
- English
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ERYTHROCYTES
CLEARANCE
MALARIA
PATHOGENESIS
SPLEEN
DYNAMIC FUNCTION STUDIES
CHROMIUM 51
INFECTIVITY
PATIENTS
PLASMODIUM
SPLENOMEGALY
TRACER TECHNIQUES
ANIMALS
BETA DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
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CHROMIUM ISOTOPES
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ELECTRON CAPTURE RADIOISOTOPES
EVEN-ODD NUCLEI
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550901* - Pathology- Tracer Techniques