Publication: Prognostic significance of skin and subcutaneous fat sequestration of parasites in severe falciparum malaria
Issued Date
2000-06-01
Resource Type
ISSN
01251562
Other identifier(s)
2-s2.0-0034203395
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Mahidol University
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SCOPUS
Bibliographic Citation
Southeast Asian Journal of Tropical Medicine and Public Health. Vol.31, No.2 (2000), 203-212
Suggested Citation
Polrat Wilairatana, Mario Riganti, Pranom Puchadapirom, Benjanee Punpoowong, Suparp Vannaphan, Rachanee Udomsangpetch, Srivicha Krudsood, Gary M. Brittenham, Sornchai Looareesuwan Prognostic significance of skin and subcutaneous fat sequestration of parasites in severe falciparum malaria. Southeast Asian Journal of Tropical Medicine and Public Health. Vol.31, No.2 (2000), 203-212. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/26235
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Title
Prognostic significance of skin and subcutaneous fat sequestration of parasites in severe falciparum malaria
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Abstract
Intradermal blood smear, histopathologic and immunohistologic studies were performed in severe malaria (n=10) and uncomplicated malaria (n=10) patients during positive parasitemia and within 6 hours after negative parasitemia by finger prick smears. Intradermal blood smears showed asexual forms and intraleukocytic pigments when finger prick blood smears showed negative results; however intradermal blood smear did not indicate disease severity within 6 hours after negative parasitemia by finger prick. Histopathologic findings showed 15 fold higher parasitized red blood cells sequestered in vessels of subcutaneous fatty tissue in severe malaria than in uncomplicated malaria (p<0.001) and may indicate disease severity. A panel of polyclonal antibodies against cytokines applied to skin biopsies clearly detected a higher titer against tumor necrosis factor-alpha (TNFα) and interleukin-10 (IL-10) in dermal vessels and stratum granulosum respectively, in severe malaria compared with uncomplicated malaria. Results of the study suggest that histopathology and immunohistology of skin and subcutaneous fatty tissue may indicate prognostic severity of malaria and may be associated with focal accumulation of cytokines.