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Title: Prognostic significance of reduced red blood cell deformability in severe falciparum malaria
Authors: Adrianus M. Dondorp
Brian J. Angus
Max R. Hardeman
Kesinee T. Chotivanich
Kamdrat Silamut
Ronatrai Ruangveerayuth
Piet A. Kager
Nicholas J. White
Johan Vreeken
Division of Infectious Diseases
Mahidol University
Mae Sot General Hospital
Dept. of Internal Medicine
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1997
Citation: American Journal of Tropical Medicine and Hygiene. Vol.57, No.5 (1997), 507-511
Abstract: Severe falciparum malaria is associated with microvascular obstruction resulting from sequestration of erythrocytes containing mature stages of the parasite. Since reduced red blood cell deformability (RBC-D) can contribute to impaired microcirculatory flow, RBC-D was measured in 23 patients with severe falciparum malaria (seven of whom subsequently died), 30 patients with uncomplicated malaria, and 17 healthy controls. The RBC-D, measured by ektacytometry, was significantly reduced in severe malaria and was particularly low in all fatal cases. At a low shear stress of 1.7 Pascal (Pa), a red blood cell elongation index less than 0.21 on admission to the hospital predicted fatal outcome with a sensitivity of 100% (confidence interval [CI] = 59-100%) and a specificity of 88% (CI = 61-98%). The reduction in the RBC-D appeared to result mainly from changes in unparasitized erythrocytes. Reduced deformability of unparasitized red blood cells in severe malaria may contribute to impaired microcirculatory flow and a fatal outcome in severe falciparum malaria.
ISSN: 00029637
Appears in Collections:Scopus 1991-2000

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