Document Detail

Plasmodium falciparum malaria in splenectomized patients: two case reports in French Guiana and a literature review.
MedLine Citation:
PMID:  15381808     Owner:  NLM     Status:  MEDLINE    
Some of the immunologic mechanisms involved in malaria physiopathology remain unclear. In animals, the spleen seems to play a key role in protecting the host against malaria. However, little is known about the effect of spleen dysfunction on human malaria. We report two severe cases of Plasmodium falciparum infection with unusual clinical and parasitologic features in two splenectomized men living in French Guiana. The peripheral blood of these cases showed hyperparasitemia, with a high proportion of mature parasites and leukocytes with malaria pigment. Despite appropriate treatment and adequate absorption, hyperparasitemia persisted. Parasite clearance was delayed and one patient died. Only the patient who died had the merozoite surface protein 1 allele B-K1 and the varD gene genotype, which is considered to be a probable parasite virulence factor. These uncommon cases differ from most of those described in the literature, illustrating the complexity of the mechanisms underlying the protective function of the spleen in human malaria.
Magalie Demar; Eric Legrand; Didier Hommel; Philippe Esterre; Bernard Carme
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  71     ISSN:  0002-9637     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-21     Completed Date:  2004-11-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  290-3     Citation Subset:  AIM; IM    
Parasitology-Mycology Laboratory, French West Indies and Guiana Faculty of Medicine and Cayenne Central Hospital (EA3593 Team), Cayenne, French Guiana.
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MeSH Terms
Antimalarials / therapeutic use
Fatal Outcome
French Guiana
Malaria, Falciparum / immunology*,  parasitology,  therapy
Merozoite Surface Protein 1 / genetics
Middle Aged
Plasmodium falciparum / genetics,  immunology,  pathogenicity*
Treatment Outcome
Reg. No./Substance:
0/Antimalarials; 0/Merozoite Surface Protein 1

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