Thrombocytopenia In P. Vivax Malaria
Thrombocytopenia In P. Vivax Malaria
Keywords:
Plasmodium Vivax Malaria, ThrombocytopeniaAbstract
Backgroud: Plasmodium Falciparum and P. Vivax are endemic infections in India and commonly associated with Hematological Abnormalities. Severe thrombocytopenia is frequently noticed with P. Falciparum Malaria, but its occurrence is less reported and studied with P. Vivax Malaria. In present study we have tried to evaluate severity & prognostic implications of thrombocytopenia in cases of P Vivax Malaria. The study was conducted in Department of Pediatrics, GMERS Medical College, Gandhinagar.Method: The study group consisted of 92 Pediatric Patients diagnosed on thick & thin blood smear examination having thrombocytopenia. The platelet counts were done by Abacus Junior B Blood Cell Counter. Result: Platelet Count <150000 Cell/mm3 (thrombocytopenia) was observed in 73.92% patients of P. Vivax Malaria. The mean platelet count 1,16,520 is significantly low and the range being 18000 cell/mm3 to 5,10,000 cells/mm3. Anaemia with mean Hemolobin level 8.8 gm/dl. was reported in the patients with P. Vivax Malaria with thrombocytopenia. Discusssion: In our view, this statistically low platelet count in P.Vivax Malaria is having significance & should be kept as differential diagnosis in Acute Febrile conditions. Unnecessary Platelet transfusions can be prevented as noticed in the study. Platelet transfusion was not required in the patients having severe thrombocytopenia (platelet count <20000 cells/mm3)as bleeding tendencies and systemic complications were not observed as compared to Falciparum Malaria. Platelet count and clinical recovery were immediate on 2nd day after initiation of treatment and complete recovery within 7 day without any complications and mortality suggest a good prognosis. Conclusion: Anaemia with severe thrombocytopenia in P. Vivax Malaria required further study to differentiate other febrile conditions with low platelet count and unaltered hemoglobin levels.
References
2. Yamaguchi S, Kubola T., Yamagishi T. et al. Severe thrombocytopenia suggesting immunological mechanism in two cases of Vivax Malaria. Am. J. Hematology 1997; 56; 183-6.
3. Looarecsuwan S., Davis I.G., Allen D.L etal. Thrombocytopenia in Malaria, southeast Asian J. Trop. Med. Public Health 1992; 23:44.4. Martelo O.J. Smoller M. Saladin T.A. Malaria in American Soldiers. Arch. Int. Medi. 1969; 123:383-7.
5. Horstmann R.D., Dietrich M. Rasche H., Malaria induced thrombocytopenia, Blood 1991;42:157-64.
6. Kakar A, Bhois, Prakash V, Kakar S, Profound thrombocytopenia in plasmodium Vivax Malaria. Diagn. Microbiol, Infect Dis.1999, 35:243-4.
7. V.M.Jadhav, V.S. Palkav. JAPI Vol.52 Aug. 2004.
8. Fajardo L.F., Tallent C. Malarial Parasites within Human Platelets Jama 1974, 229:1205.
9. Loouresuwan S, Davis I.g., Allen D.L. et al, Thrombocytopenia in Malaria southeast Asian J.A. tropical Med. Public health 1992;23(1) 44-50.
10. Yamaguchi S, Kobuta T et al. Severe thrombocytopenia suggesting immunological mechanism in two cases of Vivax Malaria. Am. J. Hematology 1997; 56(3):183-6.
11. Lee S.H. Looaresuman S., Chan j. et al. Plasma macrophage colony stimulating factor and P. Solection levels in Malaria associated Thrombocytopenia thrombhaemost. 1997, 77 (2) 289-93.
12. Evel O, Vural H., Akosyn N et al. Oxidative stress of Platelets and Thrombocytopenia in patients with Vivax malaria. Clini Biochem 2001; 34(4), 341-4. Alfanso J. Rodrigues-Morales.
13. Alfanso J. Rodrigues – Morales Anaemia and thrombocytopenia in children with plasmodium Vivax Malaria – Oxford Journal.
14. Makkar R.P., Mukhopadhyay S. Plasmodium Vivax Malaria presenting with severe thrombocytopenia Braz. J. Intectious Dis 2002, 6 263-5.
15. Lacerda MV, Alexandrema. Ideopathic thrombocytopenia purpura due to Vivax Malaria in the Brazilian Amazon. Act Prop. 2004-90, 187-90.
