Document Detail


Sequestration and Microvascular Congestion Are Associated With Coma in Human Cerebral Malaria.
MedLine Citation:
PMID:  22207648     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The pathogenesis of coma in severe Plasmodium falciparum malaria remains poorly understood. Obstruction of the brain microvasculature because of sequestration of parasitized red blood cells (pRBCs) represents one mechanism that could contribute to coma in cerebral malaria. Quantitative postmortem microscopy of brain sections from Vietnamese adults dying of malaria confirmed that sequestration in the cerebral microvasculature was significantly higher in patients with cerebral malaria (CM; n = 21) than in patients with non-CM (n = 23). Sequestration of pRBCs and CM was also significantly associated with increased microvascular congestion by infected and uninfected erythrocytes. Clinicopathological correlation showed that sequestration and congestion were significantly associated with deeper levels of premortem coma and shorter time to death. Microvascular congestion and sequestration were highly correlated as microscopic findings but were independent predictors of a clinical diagnosis of CM. Increased microvascular congestion accompanies coma in CM, associated with parasite sequestration in the cerebral microvasculature.
Authors:
Mark J Ponsford; Isabelle M Medana; Panote Prapansilp; Tran Tinh Hien; Sue J Lee; Arjen M Dondorp; Margaret M Esiri; Nicholas P J Day; Nicholas J White; Gareth D H Turner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-29
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  -     ISSN:  1537-6613     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Nuffield Department of Clinical Laboratory Sciences.
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