Abdalla S H
Haematology Department, St. Mary's Hospital Medical School, London, UK.
Blood Cells. 1990;16(2-3):401-16; discussion 417-9.
This paper presents changes in the bone marrow of patients with malaria; it is based primarily on observations of bone marrows of 89 Gambian children with P. falciparum malaria and includes a review of the literature. Erythroid hyperplasia with dyserythropoiesis was found to be more common in patients with severe anemia and low grade parasitemia than in those with acute malaria. The dyserythropoietic changes are illustrated both with light photomicropraphs and with electron micrographs. The significance of the dyserythropoiesis and possible causes are discussed. Other changes in these patients with acute malaria include lymphocytosis in the bone marrow and reactive lymphocytes, monocytosis and mild neutrophilia in the peripheral blood. Giant metamyelocytes were also commonly seen in bone marrow of patients but were thought to be part of dysmyelopoiesis and not due to B12 or folate deficiency. Phagocytosis of erythrocytes, parasitized cells and nucleated cells was more commonly seen in macrophages in acute malaria, while phagocytosis of small particles such as merozoites was observed in neutrophils. Megakaryocytes were found to be increased in number in patients with acute malaria; a proportion of these cells had rounded nuclei, probably indicating accelerated platelet turnover.
本文介绍了疟疾患者骨髓的变化；它主要基于对89名患有恶性疟原虫疟疾的冈比亚儿童骨髓的观察，并包括对文献的综述。发现重度贫血和低水平寄生虫血症患者的红系增生伴红细胞生成异常比急性疟疾患者更常见。红细胞生成异常的变化通过光学显微镜照片和电子显微镜照片进行了说明。讨论了红细胞生成异常的意义和可能的原因。这些急性疟疾患者的其他变化包括骨髓淋巴细胞增多和反应性淋巴细胞、外周血单核细胞增多和轻度中性粒细胞增多。巨晚幼粒细胞在患者骨髓中也很常见，但被认为是骨髓生成异常的一部分，而非维生素B12或叶酸缺乏所致。急性疟疾时，巨噬细胞中更常见红细胞、被寄生细胞和有核细胞的吞噬现象，而中性粒细胞中则观察到裂殖子等小颗粒的吞噬现象。发现急性疟疾患者的巨核细胞数量增加；这些细胞中有一部分细胞核呈圆形，可能表明血小板更新加速。
