Malaria: A Hematological Perspective: A Hematological Perspective

About the Series Editors......Page 6
List of Contributors......Page 8
Introduction......Page 14
Contents......Page 16
Introduction......Page 18
Samples and Methods......Page 19
Stains and Reagents......Page 20
Thin Blood Film......Page 21
Preparation of Thick Blood Film......Page 22
Thin Films......Page 23
Interpretation of Stained Thin Films (see Figs. 1–15 and Table)......Page 24
Importance of Parasitemia Estimation in P. falciparum Malaria......Page 32
Serology......Page 34
Source of Antigen......Page 35
Fluorochrome Dyes......Page 36
Antigen Detection Methods......Page 37
Advantages......Page 39
Species Determination......Page 40
Drug Resistance Detection......Page 41
References......Page 42
Definition......Page 46
Determinants of the Epidemiology of Malarial Anemia......Page 47
Malarial Endemicity, Age of the Host, and Pregnancy......Page 48
Associated Host Genetic Factors......Page 50
Other Nonmalarial Causes of Anemia......Page 51
Morbidity and Mortality of Severe Malarial Anemia......Page 52
The Natural History of Malarial Anemia......Page 54
Clinical Features of the Anemia of Malaria......Page 55
Diagnostic Aspects of the Anemic Patient with Malaria......Page 56
Blood Film Appearances......Page 57
Reticulocyte Counts......Page 58
Haptoglobins......Page 59
Serum Ferritin......Page 60
Bone Marrow Appearances......Page 61
Antimalarials......Page 62
Blood Transfusion......Page 63
Exchange Transfusion (see also Chapter 12)......Page 66
Hematinics......Page 68
Antihelminthics......Page 69
Antimalarial Chemoprophylaxis......Page 70
References......Page 71
Introduction......Page 78
Anemia in Different Clinical Settings of Malaria......Page 79
Mechanisms of Anemia in Malaria (Table 1)......Page 80
Destruction of Parasitized Cells by Maturation of Parasites......Page 81
Action of Antimalarials......Page 82
Removal by the RE System......Page 83
Nonimmune Mechanisms of Red Cell Loss......Page 86
Nonspecific Increased Reticuloendothelial and Splenic Function (Hypersplenism)......Page 87
Decreased Deformability of Red Cells......Page 88
Immune Mechanisms of Red Cell Loss......Page 89
Age, Malaria Endemicity and Parasitemia......Page 91
Quantitation and Subgroup Specificity of Immunoglobulin Sensitization......Page 92
Role of Complement Activation......Page 93
Antigen Specificity of IgG on Red Cells of Patients with a Positive DAT and Malaria......Page 94
Conclusions Regarding the Significance of the Positive DAT in Malaria......Page 95
Blackwater Fever......Page 97
Hemophagocytosis-like Syndrome in Patients with Malaria......Page 100
In Acute Malaria......Page 101
In Chronic Malaria......Page 102
Conclusions......Page 104
References......Page 105
Iron and Malaria......Page 114
Iron Metabolism of Malaria Parasites......Page 115
Iron Chelators and Malaria......Page 116
Iron and Antimalarials......Page 119
Iron Parameters in Patients with Malaria......Page 120
Hematological Parameters Used to Assess the Iron Status in Patients with Malaria......Page 121
Biochemical Parameters Used to Assess the Iron Status in Patients with Malaria......Page 122
The Effects of Iron Deficiency and Iron Treatment on the Clinical Course of Malaria......Page 128
Conclusions......Page 132
Folate Metabolism in Malaria Parasites and Effects of Antimalarials......Page 133
Folate Deficiency and Folate Supplementation and the Anemia of Malaria......Page 135
Conclusions......Page 137
References......Page 139
Introduction......Page 146
Total Leukocyte Counts......Page 147
Neutrophils......Page 148
Lymphocytes and Subsets......Page 149
γδ+ T Lymphocytes......Page 152
Monocytes......Page 153
Eosinophils......Page 154
Granulocyte Series......Page 156
Monocytes and Macrophages......Page 157
Significance of the White Cell Changes in the Bone Marrow in Comparison with Those in the Blood......Page 158
Morphological Changes in White Cells in Malaria......Page 159
Ultrastructural Changes of White Cells......Page 162
Phagocytosis in Malaria......Page 166
Morphological Features of Phagocytosis in Malaria......Page 168
Kinetics and Significance of Malaria Pigment in Phagocytic Cells......Page 170
Phagocytic Cell Function in Malaria......Page 171
In Vitro Phagocytosis......Page 172
Other Changes Related to Phagocytic Cells in Malaria......Page 174
Conclusions......Page 175
References......Page 177
Tumor Necrosis Factor......Page 186
Interleukin 1 (IL-1)......Page 190
Clinical Data......Page 191
Experimental Data: Factors Causing Release of IFN-γ from Lymphocytes......Page 192
Interleukin 6 (IL-6)......Page 194
Chemokines and Receptors......Page 196
Interleukin 12 (IL-12)......Page 198
In Vivo Levels......Page 199
Ex Vivo......Page 200
Postulated Mechanisms of Protective Effects of IL-10 in Patients with Malaria......Page 201
Interleukin 4 (IL-4)......Page 202
Transforming Growth Factor Beta (TGF-β)......Page 203
Other Cytokines......Page 204
Nitric Oxide and iNOS......Page 205
Triggers of Cytokine Release in Malaria......Page 208
Conclusions......Page 213
References......Page 215
Asexual Stages......Page 230
Sexual Stages......Page 233
The Diagnostic Value of Bone Marrow Aspiration in Malaria......Page 234
Introduction......Page 235
Erythropoiesis......Page 236
Qualitative Changes......Page 238
Distribution of Hemosiderin......Page 241
Numerical Changes......Page 244
Megakaryocytes......Page 245
Ultrastructural Changes Affecting Human Bone Marrow in Malaria*......Page 246
Cell Cycle Studies......Page 250
The Deoxyuridine (dU) Suppression Test......Page 253
Progenitor Cells......Page 254
The Postulated Causes of Dyserythropoiesis in Malaria......Page 256
Host-Generated Molecules......Page 258
Is Dyserythropoiesis Advantageous in Malaria?......Page 260
References......Page 261
Introduction......Page 266
Changes in the Platelet Count......Page 267
Splenic Pooling......Page 268
Platelet Aggregation and Activation......Page 269
Antibody-Mediated Mechanisms......Page 270
Platelet Phagocytosis......Page 271
Hyperreactive Malarial Splenomegaly......Page 272
Pro- and Anticoagulant Mediator Abnormalities......Page 273
Disseminated Intravascular Coagulation......Page 275
Malaria Pathogenesis, Platelets and Coagulation......Page 277
Antimalarial Drugs and Platelets......Page 280
Clinical Management—Malaria, Platelets and Coagulation......Page 282
References......Page 284
Introduction......Page 294
Innate Resistance to Malaria Conferred by Hemoglobinopathies......Page 295
P. falciparum Malaria and Sickle Hemoglobin (HbS)......Page 296
Malaria and the HbC Trait and HbC Disease......Page 299
Malaria and HbSC Disease......Page 301
Malaria and HbE......Page 302
Neonatal Red Cells and Red Cells Containing HbF......Page 303
Malaria and β-Thalassemia......Page 305
Malaria and α-Thalassemia......Page 308
Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Malaria......Page 309
Southeast Asian Ovalocytosis......Page 313
Hereditary Elliptocytosis......Page 315
Hereditary Spherocytosis......Page 316
Serology, Protein Chemistry and Ethnic Distribution......Page 318
Duffy and Var Genes and Adhesion......Page 319
Complement Receptor 1 Knops Blood Group, ABO Blood Groups and Malaria......Page 320
Glycophorin Deficiency......Page 321
References......Page 323
Incidence of Splenomegaly in Malarious Areas......Page 334
Hackett’s Classification of Splenomegaly......Page 335
Splenic Ultrasound......Page 336
Histology of the Spleen in Malaria......Page 337
Rupture of the spleen......Page 338
Hypersplenism......Page 339
Reticuloendothelial Function in Malaria......Page 340
Structure of the Spleen......Page 341
Functional Hyposplenism and Susceptibility to Malaria......Page 343
Causes of Massive Splenomegaly in Malaria-Endemic Areas......Page 344
Prevalence and Epidemiology of HMS......Page 345
Pathogenesis of HMS......Page 346
Major Criteria......Page 347
Minor Criteria......Page 348
Clinical Features of HMS......Page 349
Clinical Course......Page 350
Development of Lymphoma......Page 351
References......Page 353
Introduction......Page 362
The Epstein–Barr Virus......Page 363
Virus Cycle and Gene Expression......Page 366
Immunological Control of EBV and Tumor Cells......Page 369
Role of EBV in the Etiology of eBL......Page 370
Epidemiology of Endemic BL and Malaria Transmission......Page 371
Presentation......Page 375
Clinical Features......Page 376
Management and Prognosis......Page 377
Molecular Basis for Lymphomagenesis......Page 379
Interchromosomal Translocations and Molecular Consequences......Page 380
Molecular Epidemiology of Translocations......Page 382
Accumulation of Multiple Genetic Lesions, Proliferation and Inhibition of Apoptosis......Page 384
Established Geographical and Other Evidence......Page 386
Immunosuppression and Disrupted Immunosurveillance......Page 389
EBV in Lymph Nodes from Children with Malaria......Page 390
Cytokine Dysregulation......Page 391
Chronic Antigen Stimulation, Polyclonal B Cell Activation and Germinal Center Hyperactivity......Page 393
Chromosomal Translocations in Children with Malaria......Page 395
Molecular Pathology......Page 399
Acknowledgements......Page 403
References......Page 404
History......Page 414
Risk Factors......Page 415
Identifying Potential Malaria Risk......Page 416
Antibody Testing......Page 418
Nucleic Acid Testing......Page 421
US Strategy (7)......Page 422
Drug Treatment of TTM......Page 424
Introduction......Page 425
Experience in the Use of Exchange Transfusion......Page 426
Indications for the Use of Exchange Transfusion......Page 429
Technique......Page 431
References......Page 433
Index......Page 438