Article summary: Prognostic significance of reduced red blood cell deformability in severe falciparum malaria.

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Severe infection with Plasmodium falciparum remains a major cause of death in the tropics. It is associated with Run microvascular obstruction resulting from sequestration of red blood cells (RBC’s) containing mature stages of the parasite. The parasitized RBC’s impede the passage of the uninfected red blood cells, which are forced to deform more than usual in their transit through the microcirculation. The relationship between RBC deformability (RBC-D) and disease severity in falciparum malaria was investigated in this study.

The RBC-D cheap nba jerseys 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. Patients with acute falciparum malaria seem to have less deformable RBC’s than healthy subjects and this rigidity increases with increasing severity of the infection. It showed severely reduced RBC-D (El < 0.21) at a shear stress of 1.7 Pa predicted fatal outcome with a sensitivity of 100% (confidence interval (CI) = 59-100%)) and a specificity of 88% (CI = 61-98%).

Since the majority of RBC’s even in severe malaria is Aachen uninfected, this reduction in RBC-D results mainly from changes in the unparasitized RBC’s. Reduced deformability of unparasitized RBC’s in severe malaria may contribute to impaired microcirculatory flow and a fatal outcome in severe falciparum malaria. If reduced RBC-D is a cause rather than an effect of potentially lethal organ dysfunction in severe malaria, then measures to correct this abnormality may save lives. The mechanisms underlying the reduction in RBC-D of uninfected cells cheap MLB jerseys in severe Perfecta malaria are Restaurierung! not known. There was no cell significant increase in RBC-D during the time of admission, or shortly dringend after recovery, suggesting irreversible damage to the uninfected red blood cells.

In conclusion, this study shows that the mean RBC-D is an important predictor of and may be a contributor to Wholesale Miami Dolphins Jerseys mortality in severe falciparum malaria.

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