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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten days after his return from Cameroon, a twenty-six year old Frenchman, serving on voluntary service overseas, presented with fulminant falciparum malaria: shock, altered consciousness, haemolytic anaemia, threatening disseminated coagulation (platelets less than 150 X 10(-6).l-1; prothrombin time and Stuart factor less than 50%; fibrinogen less than 1.5 g.l-1). In spite of quinine therapy, parasitaemia increased from 4 to 35% within 24 h. Using an Haemonetics V50, the exchange of one and a half red blood cell masses was carried out with 17 red blood cell packs. Calcium gluconate was used to prevent the hypocalcaemia induced by the anticoagulant solution. The patient's platelets and plasma were completely reinjected. The result was very satisfactory. This kind of exchange, well tolerated clinically and biologically, would seem better than the classical exchange transfusion. When 10% of the red blood cells are infected by Plasmodium falciparum, it is necessary to exchange from one and a half to two blood masses. Lesser exchanges are always associated with important relapses and quinine therapy must be carried on during and after the exchange. Restricting this exchange only to red blood cells enabled the patient to benefit from his own coagulation factors, antibodies and platelets, and consequently to reduce the number of blood donors involved. However, metabolites (especially bilirubin and circulating immune complexes) were not eliminated. Partial plasmapheresis may be associated with erythropheresis using human albumin as plasma substitute. This technique needs to be assessed, in order to optimize immediate efficiency and post-transfusion infectious risk.
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PMID:[Treatment of fulminant falciparum malaria with erythrapheresis]. 304 6

Swiss albino mice were infected by the intraperitoneal route with P. berghei berghei malaria parasite, and platelets, white cell counts and some coagulation parameters were monitored in order to find out whether changes reported in man also occurred in the mice. Parasitaemia developed form the 2nd post-infection day and reached significant levels by the 4th-6th day. Reduced circulating platelets which reached severe thrombocytopenic levels were observed. parallel with the increasing degree of parasitaemia. Anaemia which progressed to severe degree was also observed as was a slight leucocytosis attributed to the presence of normal mouse erythrocytes in the peritoneal space. All untreated animals died by the 6th day of infection. Intramuscular chloroquine sulphate (20 micrograms/g body wt.) given for 7 days completely cured the malaria, and white cell and platelet counts were restored to preinfection levels in each animal about 2 weeks after treatment had ceased. Platelet hypersensitivity to exogenous ADP was observed within 48 hours of infection and persisted with the parasitaemia. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged while clottable fibrinogen concentration was reduced.
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PMID:Platelet reactions in acute Plasmodium berghei infection in Swiss albino mice. 330 58

Traditionally, blood rheology tests have been used in diagnosis and monitoring of infection, rheumatic diseases and malignancy, and are still of clinical value in these conditions. In the last twenty years, clinical and epidemiological studies have shown that the haematological determinants of blood flow resistance (haematocrit, fibrinogen, white cell count and altered red and white cell rigidity) are also associated with nutritional, metabolic, endocrine and vascular disorders. Decreased red cell deformability may contribute to reduced red cell survival and anaemia in burns, malaria, liver disease and kidney failure. In trauma and inflammatory disease, overt hyperviscosity is usually prevented by vasodilatation and reduction in the haematocrit. However, low-flow states may arise systemically from haemoconcentration (contracted plasma volume, Chapter 3) in severe burns, inappropriate red cell transfusion, or dehydration due to illness; systemically in circulatory shock; and locally in venous thrombosis or arterial disease. In such circumstances, the intrinsic flow resistance of blood may perpetuate flow disturbance, ischaemia and thrombosis. Conversely, optimal levels of haematocrit, fibrinogen and white cell count may be lower than normal in low-flow states. Haemodilution by colloid infusion is beneficial in burns, shock, major surgery, prevention of postoperative venous thrombosis, chronic stable claudication and possibly in acute stroke and retinal vein thrombosis. Plasma exchange may be beneficial in severe Raynaud's phenomenon. Defibrination with ancrod is effective in prevention and treatment of venous thrombosis but its role in arterial disease is unproven. The benefits of streptokinase therapy in venous thrombo-embolism and acute myocardial infarction may be partly rheological, due to fibrinogen depletion. Drugs with rheological effects may be beneficial in intermittent claudication.
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PMID:Blood rheology in general medicine and surgery. 332 67

The mechanism of thrombocytopenia in six patients with falciparum malaria has been studied. All the patients recovered after antimalarial therapy, and cerebral malaria was not a feature. Radioactive-labelled platelets and fibrinogen were injected into the patients during the phase of thrombocytopenia. In all cases recovery of injected platelets was notably subnormal, indicating excessive splenic pooling of platelets. Platelet life span was moderately shortened in all patients, and platelet turnover increased approximately two-fold. Fibrinogen catabolism was moderately increased in all patients, but coagulation tests failed to reveal evidence of disseminated intravascular coagulation. The results suggest that in uncomplicated cases of malaria thrombocytopenia is the result of splenic pooling of platelets aggravated by a moderate decrease in platelet life span. In such cases thrombocytopenia is thus not the result of disseminated intravascular coagulation (D.I.C.), and heparin therapy is not indicated unless there is unequivocal ancillary evidence of D.I.C.
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PMID:Mechanisms of thrombocytopenia in malignant tertian malaria. 471 66

Nonspecific immunity (NSI) was manifested in rats injected intravenously with killed Corynebacterium parvum and challenged with Trypanosoma lewisi, Plasmodium chabaudi, or Babesia rodhaini. The NSI became evident some 5 days after infection as a suppressed parasitemia, a more rapid recovery from patent infection and as enhanced survival among rats infected with B. rodhaini. The C. parvum injections produced anemia and thrombocytopenia with splenomegaly and signs of glomerulonephritis in rats. The signs became evident about 5 days after injection and were accompanied by reduced titers of lytic complement, elevated titers of antibody against fibrinogen products (Anti-F), antibody against soluble serum antigen of malaria and babesiosis (ABSA), and antibody against the third component of fixed complement or immunoconglutinin (IK). These were the autoantibodies associated with anemia and reduced parasitemia of infection-induced NSI. In as much as immunoconglutination of blood cells or parasites coated with complement fixing immune complexes was implicated as a functional mechanism in infection-induced NSI, it is possible that these same factors might function in C. parvum induced NSI.
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PMID:Anemia and thrombocytopenia from Corynebacterium parvum-stimulated resistance against malaria, trypanosomiasis, and babesiosis. 635 27

The transcapillary escape rate and capillary permeability of fibrinogen were studied in 7 patients wih Plasmodium falciparum malaria and 4 control subjects by using 131I-fibrinogen as a tracer. The plasma disappearance curve of 131I-fibrinogen was followed during the first 60 minutes after injection. The mean transcapillary rate of fibrinogen in these patients was found to be significantly higher than that of the control group. As the plasma volume and fibrinogen concentrations were grossly elevated in these patients, this resulted in a significantly higher plasma clearance, intravascular pool of fibrinogen and out-flux of fibrinogen from the intravascular to the extravascular compartments. Both the effective capillary pore area per unit path length available for restricted diffusion and the specific permeability coefficient of plasma fibrinogen were increased in the patients group which indicated that the increased leakage of fibrinogen was due to the increased surface area of capillary membrane and an increased capillary permeability to fibrinogen. The mean extravascular transit time for fibrinogen to return to plasma via the lymph was slightly, but not significantly shorter in the patients group than the control group. All these findings indicated that there was an increased capillary permeability in patients with P. falciparum malaria which resulted in the increased leakage of plasma fibrinogen from the circulation into the extravascular space.
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PMID:Studies on the transcapillary escape rate of fibrinogen and capillary permeability in patients with Plasmodium falciparum malaria. 638 24

6 Aotus trivirgatus monkeys, which had all spontaneously recovered from an experimentally induced Plasmodium falciparum infection, were included in a clinical study concentrating on possible adverse reactions caused by a vaccine using late schizonts and merozoites as an antigen a synthetic compound, CP-20,961, as an adjuvant. Two monkeys in the study were vaccinated once, 2 twice, 1 received adjuvant alone and 1 served as a saline control. Local and general inflammatory reactions as indicated by local oedema, induration, femoral lymphadenopathy, fever and leukocytosis, were observed in all vaccinated animals and in the one monkey after the second adjuvant injection. Serum albumin and transaminase enzyme levels increased in all animals whereas plasma fibrinogen, protamine sulfate and ethanol gelation titers rose only inthe vaccinated monkeys. A transient increase of alkaline phosphatase and erythrocyte sedimentation rate was noticed in half of them. We conclude that this type of malaria vaccine causes moderate adverse reactions in Aotus but they are transitory and seem not to lead to permanent damage.
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PMID:Plasmodium falciparum merozoite vaccination in Aotus monkeys recovered spontaneously from P. falciparum infection: a clinical study. 675 60

A fatal female case of cerebral falciparum malaria who was accidentally, artificially and directly infected in Japan through nursing an imported falciparum malaria was experienced. These observations raised a question as to whether the disseminated intravascular coagulation (DIC) would occur in falciparum malaria. Then, 84 Congolese patients with uncomplicated falciparum malaria were studied on the coagulation. Serum fibrin-degradation products (FDP) levels were only slightly raised (10-40 microgram/ml) in 4 cases out of 84 (5%). Thrombocytopenia, elongation of prothrombin time and low fibrinogen concentration were found in 24 out of 57 (42%), in 11 out of 47 (23%) and in 11 out of 46 (24%), respectively. Relations between FDP level and the other observations were not significant. It is suggested that there is no evidence of intravascular coagulation at least in uncomplicated falciparum malaria.
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PMID:Fibrin-degradation products in falciparum malaria. 703 50

Plasma Fibrinopeptide-A (FpA) concentrations were determined using Enzyme-linked Immunosorbent Assay (ELISA) in patients with acute Plasmodium falciparum malaria infection and in 30 healthy controls. The mean FpA levels of the malaria patients were significantly raised (p < 0.001). The patients' FpA level correlated positively with malaria parasitaemia, but negatively with plasma fibrinogen concentration. A week after commencement of chloroquine therapy and subsequent disappearance of malaria parasites from the thick blood films, the patients' FpA levels decreased significantly from pre-treatment values. It is suggested that the elevated FpA and reduced plasma fibrinogen levels in the patients probably indicate a more widespread existence of overt coagulation defect in acute malaria infection.
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PMID:Effect of Plasmodium falciparum malaria on plasma fibrinopeptide-A (FpA) concentration. 778 83

The pathogenesis of renal diseases associated with Plasmodium malariae infections is still not fully understood. The present work is concerned with the infection caused by P. inui in the rhesus monkey Macaca mulatta as a potential model for human quartan malaria, which the monkey parasite resembles in morphology and schizogonic behavior. Various aspects of the disease were studied. Changes in the levels of serum complement components C3 and C4 indicate activation of complement through the classical pathway. A few days after infection, IgG antibody titers increased, coinciding with low levels of parasitemia, which suggests that some of these antibodies are protective. Immunofluorescence testing of kidney tissue showed a predominance of IgM antibodies over IgG, C3, C4, albumin, and fibrinogen, which was detected in a number of the infected monkeys. These findings were consistent with those seen in humans with P. malariae infection and indicate that the P. inui/rhesus monkey model is likely to be appropriate for the study of different aspects of quartan malaria.
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PMID:Immune complexes and nephropathies associated with Plasmodium inui infection in the rhesus monkey. 807 52


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