Publication: Plasma macrophage colony-stimulating factor and P-selectin levels in malaria-associated thrombocytopenia
Issued Date
1997-02-01
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ISSN
03406245
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2-s2.0-0031045615
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Mahidol University
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SCOPUS
Bibliographic Citation
Thrombosis and Haemostasis. Vol.77, No.2 (1997), 289-293
Suggested Citation
S. H. Lee, S. Looareesuwan, J. Chan, P. Wilairatana, S. Vanijanonta, S. M. Chong, B. H. Chong Plasma macrophage colony-stimulating factor and P-selectin levels in malaria-associated thrombocytopenia. Thrombosis and Haemostasis. Vol.77, No.2 (1997), 289-293. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/18167
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Title
Plasma macrophage colony-stimulating factor and P-selectin levels in malaria-associated thrombocytopenia
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Abstract
Thrombocytopenia is a common finding in malaria. In clinical trials, recombinant macrophage colony-stimulating factor (M-CSF) causes a reversible, dose-dependent thrombocytopenia, and high M-CSF has been reported in autoimmune thrombocytopenias. P-selectin, which is secreted into the plasma following platelet/endothelial activation or damage, is elevated in certain consumptive thrombocytopenic disorders. The relationships between thrombocytopenia, M-CSF and P-selectin were analysed in 63 patients with severe (n = 13) or uncomplicated (n = 26) P. falciparum (PF) or P. vivax (PV) malaria (n = 24). On admission, 69% of PF patients and 75% of PV patients were thrombocytopenic (platelets < 150 x 109/l). M-CSF was elevated in PF (3021 ± 1844 pg/ml) and PV (2602 ± 1668 pg/ml) patients, compared to controls (589 ± 200 pg/ml). The platelet count was inversely correlated with M-CSF in PF (r = -0.681), and in PV malaria (r = -0.548). Elevated P-selectin was found in severe PF malaria, but not in PV malaria. Severe PF malaria was associated with marked thrombocytopenia, very high M-CSF, elevated P-selectin and compelling evidence of disseminated intravascular coagulopathy (DIC). Platelet counts, M-CSF and P-selectin returned to control values in 7-14 days. These data suggest that elevated M-CSF in malaria, by enhancing macrophage activity, may result in increased macrophage-mediated platelet destruction. Further, platelet/endothelial activation or damage, as measured by P-selectin, or DIC could intensify thrombocytopenia in severe PF malaria, but does not appear to contribute to thrombocytopenia in uncomplicated PF or PV malaria.