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Anaemia of acute malaria infections in non-immune patients primarily results from destruction of uninfected erythrocytes

Published online by Cambridge University Press:  01 August 1999

G. N. JAKEMAN
Affiliation:
School of Applied Mathematics and Statistics, Griffith University, Nathan, Queensland, 4111, Australia
A. SAUL
Affiliation:
The Queensland Institute of Medical Research and University of Queensland, PO Royal Brisbane Hospital, Herston, Queensland, 4029, Australia
W. L. HOGARTH
Affiliation:
Australian School of Environmental Studies, Griffith University, Nathan, Queensland, 4111, Australia
W. E. COLLINS
Affiliation:
Division of Parasitic Diseases, Mail Stop F-12, Center for Disease Control and Prevention, 4770 Buford Highway, Chamblee, GA 30341, USA

Abstract

While anaemia has long been recognized as a consequence of acute infections with malaria, the relative contributions of direct erythrocyte destruction by parasites, destruction of uninfected erythrocytes and changes in erythropoiesis have been unclear. Fitting of parasitaemia and anaemia data from neurosyphilis patients undergoing malaria therapy to a mathematical model shows that in these patients, an average of 8·5 erythrocytes were destroyed in addition to each erythrocyte observed to become parasitized. The model also showed that dyserythropoiesis plays an insignificant role in the resulting anaemia. The anaemia occurs before a substantial antibody response to parasites or erythrocytes could be generated. We postulate that uninfected erythrocyte destruction occurs through phagocytosis of erythrocytes bound to merozoites killed as a result of the accompanying malaria paroxysms.

Type
Research Article
Copyright
1999 Cambridge University Press

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