Roy Somnath, Saha Debashree Roy, Ahmed Rashmi, Sharma Narayan C, Mahanta Putul
Internal Medicine, Gauhati Medical College and Hospital, Guwahati, IND.
Dermatology, Nalbari Medical College and Hospital, Nalbari, IND.
Cureus. 2024 Jul 2;16(7):e63690. doi: 10.7759/cureus.63690. eCollection 2024 Jul.
Introduction Malaria is the most common parasitic disease affecting humans. Haematological alterations in malaria are expected, and these changes play a significant role in fatal complications. The present study aims to assess the clinical and haematological profile in patients with acute falciparum malaria and the significance of various haematological and coagulation alterations with the clinical severity of malaria. Methods The prospective cross-sectional study included 68 acute falciparum malaria cases. Thick and thin blood film microscopy and a rapid diagnostic kit were used to diagnose malaria. The cases were subjected to various haematological and biochemical investigations. Bone marrow aspiration samples were also collected. Using appropriate statistical methods, the findings were compared between severe and uncomplicated malaria cases. A p-value below 0.05 was considered significant. Results The participants' ages ranged from 14 to 78. Most participants (n = 51, 75%) were male and belonged to the lower income group (33, 48.5%). Significant variations in mean parasite count between severe and uncomplicated malaria cases (p-value < 0.01) were observed. The severe and uncomplicated groups showed significant differences in haemoglobin (gm/dL), haematocrit, red blood cell count, reticulocyte, serum iron, and ESR levels (p-value < 0.05). The severe malaria group had considerably reduced mean platelet counts (p-value < 0.01). Only five instances (7.3%) had an appropriate erythropoietic response after day 28. Erythroid hyperplasia with dyserythropoietic alterations was most common in patients with severe anaemia and low-grade parasitaemia. Conclusion Acute falciparum malaria is often associated with haematological alterations. Anaemia and thrombocytopenia were the most expected alterations associated with disease prognosis and mortality.
引言
疟疾是影响人类的最常见寄生虫病。疟疾患者出现血液学改变是预料之中的事,且这些变化在致命并发症中起重要作用。本研究旨在评估急性恶性疟患者的临床和血液学特征,以及各种血液学和凝血改变与疟疾临床严重程度的相关性。
方法
这项前瞻性横断面研究纳入了68例急性恶性疟病例。采用厚血膜和薄血膜显微镜检查以及快速诊断试剂盒诊断疟疾。对病例进行各种血液学和生化检查。还采集了骨髓穿刺样本。使用适当的统计方法,比较重症和非重症疟疾病例的研究结果。p值低于0.05被认为具有统计学意义。
结果
参与者年龄在14至78岁之间。大多数参与者(n = 51,75%)为男性,属于低收入群体(33人,48.5%)。观察到重症和非重症疟疾病例之间平均寄生虫计数存在显著差异(p值<0.01)。重症和非重症组在血红蛋白(克/分升)、血细胞比容、红细胞计数、网织红细胞、血清铁和血沉水平方面存在显著差异(p值<0.05)。重症疟疾组的平均血小板计数显著降低(p值<0.01)。仅5例(7.3%)在第28天后有适当的红细胞生成反应。红细胞增生伴异常红细胞生成改变在重度贫血和低度寄生虫血症患者中最为常见。
结论
急性恶性疟常伴有血液学改变。贫血和血小板减少是与疾病预后和死亡率相关的最常见改变。