RESPONSE OF PLASMODIUM VIVAX MALARIA INDUCED THROMBOCYTOPENIA TO ANTIMALARIAL TREATMENT
AbstractBackground: Thrombocytopenia is often seen in the patients of malaria infected with Plasmodium vivax. We studied patients admitted in hospital having coexisting thrombocytopenia and malaria, and recorded the response to anti-malarial therapy. Methods: In this cross-sectional descriptive study, a total of 120 patients admitted in medical ward with Plasmodium vivax malaria and co-existing thrombocytopenia were studied. Results: Out of total 120 slide positive Malaria patients who had low platelet count (<150×109 /L), platelet count increased to ≥150×109 /L in 73 (60.8%) patients after five days of anti-malarial therapy while in 47 (39.2%) patients thrombocytopenia persisted. After ten days of anti-malarial therapy, platelet count in all the patients recovered to ≥150×109 /L. None of the patients required platelet transfusion. Conclusion: In majority of the patients of Plasmodium vivax malaria having thrombocytopenia, platelet count returns to normal within five to ten days of start of anti-malarial treatment and platelet transfusion is not required.Keywords: Malaria, thrombocytopenia, Plasmodium vivax, Chloroquine
Jadhav UM, Patkar VS, Kadam NN. Thrombocytopenia in malaria--correlation with type and severity of malaria. J Assoc Physicians India 2004;52:615–8.
World Health Organization. A global strategy for malaria control. Geneva WHO 1993;30.
Mujahid CA, Arif M. Malaria situation in Pakistan to brief on National control programme. Pak J Med Res 1998;37:537–9.
Ali B, Hashmi KZ. Prevalence of malaria among Karachites. Past and Present. Inf Dis J Pak 1997;4–9.
Struchler D. Global epidemiology of malaria. Schlagen Hallf P (ed). Travelers malaria 2001. BC Decker London, p. 14–55.
Khan SA, Ali W, Hashmi SN, Luqman M, Latif T. Platelet count in malaria. Pak J Pathol 2008;19(3):86–8.
Casals-Pascual C, Kai O, Newton CR, Peshu N, Roberts DJ. Thrombocytopenia in falciparum malaria is associated with high concentrations of IL-10. Am J Trop Med Hyg 2006;75:434–6.
Asif N. Malaria in Shorkot garrison- a four years experience report. Pak J Pathol 2011;22(2):58–64.
Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CR. Changes in white blood cells and platelets in children with falciparum malaria: Relationship to disease outcome. Br J Haematol 2002;119:839–47.
Newton P, Essien E, White NJ, 2004. Platelets and blood coagulation in human malaria. Abdalla SH, Pavol G, eds. Malaria: A Haematological Perspective. London: Imperial College Press, p. 249–74.
Kreil A, Wenisch C, Brittenham G, Looareesuwan S, Peck- Radosavljevic M. Thrombopoietin in Plasmodium falciparum malaria. Br J Haematol 2000;109:534–6.
Kathryn NS, Kevin C, Jay SK. Malaria. Canadian Med Assoc J 2004;170:1503–18.
Patel U, Gandhi G, Friedman S, Niranjan S. Thrombocytopenia in malaria. J Natl Med Assoc 2004;96:1212–4.
Memon AR, Afsar S. Thrombocytopenia in hospitalized patients. Pak J Med Sci 2006;22:141–3.
Ansari S, Khoharo HK, Abro A, Akhund IA, Qureshi F. Thrombocytopenia in plasmodium falciparum malaria. J Ayub Med Coll Abbottabad 2009;21:145–7.
Sosman JA, Verma A, Moss S, Sorokin P, Blend M, Bradlow B, et al. Interleukin 10-induced thrombocytopenia in normal healthy adult volunteers: Evidence for decreased platelet production. Br J Haematol 2000;111:104–11.
Khan SJ, Khan FR, Usman M, Zahid S. Malaria can lead to Thrombocytopenia. Rawal Med J 2008;33(2):183–5.
Baird JK. Resistance to therapies for infection by Plasmodium vivax. Clin Microbiol Rev 2009;22(3):508–34.
Price RN, Douglas NM, Anstey NM. New developments in Plasmodium vivax malaria: severe disease and the rise of chloroquine resistance. Curr Opin Infect Dis 2009;22(5):430–5.
González B, Rodulfo H, De Donato M, Berrizbeitia M, Gómez C, González L. Hematologic variations in patient with malaria caused by Plasmodium vivax before, during and after treatment. Invest Clin 2009;50(2):187–201.
Kakar A, Bhoi S, Prakash V, Kakar S. Profound thrombocytopenia in Plasmodium vivax malaria. Diagn Microbiol Infect Dis 1999;35(3):243–4.
Makkar RP, Mukhopadhyay S, Monga A, Monga A, Gupta AK. Plasmodium vivax malaria presenting with severe thrombocytopenia. Braz J Infect Dis 2002;6(5):263–5.
Thapa R, Biswas B, Mallick D, Sardar S, Modak S. Childhood Plasmodium vivax malaria with severe thrombocytopenia and bleeding manifestations. J Pediatr Hematol Oncol 2009;31(10):758–9.
Metanat M, Sharifi-Mood B. Malaria vivax and Severe Thrombocytopenia in Iran. Iran J Parasitol 2010;5(3):69–70.
Tanwar GS, Khatri PC, Chahar CK, Sengar GS, Kochar A, Tanwar G. Thrombocytopenia in childhood malaria with special reference to P. vivax monoinfection: A study from Bikaner (Northwestern India). Platelets 2012;23(3):211–6.