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Hematological and coagulation studies in malaria.

S Rojanasthien1, V Surakamolleart, S Boonpucknavig

  • 1Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|January 1, 1992
PubMed
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Malaria patients, particularly those with Plasmodium falciparum, exhibit significant hematological abnormalities including anemia and thrombocytopenia. Plasmodium falciparum infections also show increased plasmin activity and coagulation defects, potentially linked to liver involvement and disseminated intravascular coagulation (DIC).

Area of Science:

  • Hematology
  • Infectious Diseases
  • Coagulation Science

Background:

  • Malaria, caused by Plasmodium parasites, is a significant global health concern.
  • Hematological abnormalities are common in malaria patients, but specific coagulation and fibrinolysis patterns vary by Plasmodium species.

Purpose of the Study:

  • To investigate hematological coagulation and fibrinolysis abnormalities in patients with Plasmodium vivax and Plasmodium falciparum malaria.
  • To correlate these abnormalities with parasitemia levels and disease severity.

Main Methods:

  • Studied 126 malaria patients (30 P. vivax, 96 P. falciparum) for hematological parameters.
  • Assessed coagulation profiles (PT, aPTT, TT), plasmin activity, and coagulation factors.
  • Correlated findings with parasitemia and clinical presentation.

Related Experiment Videos

Main Results:

  • Anemia and significantly increased plasmin activity were observed in P. falciparum malaria, especially with >5% parasitemia.
  • Thrombocytopenia was prevalent in both P. vivax and P. falciparum malaria, correlating with parasitemia.
  • P. falciparum infections showed prolonged PT and aPTT, linked to liver involvement; 2 complicated cases presented with disseminated intravascular coagulation (DIC).

Conclusions:

  • Plasmodium falciparum malaria is associated with more severe hematological and coagulation disturbances than P. vivax malaria.
  • Coagulation defects in falciparum malaria are often related to liver dysfunction and can progress to DIC.
  • Thrombocytopenia and altered coagulation profiles serve as important indicators of malaria severity.