The eosinophilic response and haematological recovery after treatment for Plasmodium falciparum malaria.
To examine a possible relationship between the immune response and haematological recovery after acute falciparum malaria, we followed peripheral blood eosinophil counts and haemoglobin concentrations for 4 weeks after starting effective treatment in 70 adult Thai patients. Eosinophils are induced by Th-2 cytokines as well as other stimuli. Eosinophil counts were elevated in only 8 (11%) of the subjects at presentation, but were increased in 65 (93%) by day 7. Eosinophil counts then decreased markedly by day 14, followed by a second increase until day 28. A significant positive correlation was found between peak eosinophil counts on day 7 and the haemoglobin concentration on day 28, both in 16 subjects without stool parasites (r = 0.65, P = 0.006) and in 54 patients with stool parasites (r = 0.32; P = 0.0019). These results suggest that a robust eosinophilic response shortly after completing antimalarial therapy predicts a good recovery from malaria-associated anaemia.
Camacho
L H
LH
Department of Medicine, George Washington University Medical Center, Washington DC, USA. lhcama@rocketmail.com
Wilairatana
P
P
Weiss
G
G
Mercader
M A
MA
Brittenham
G M
GM
Looareesuwan
S
S
Gordeuk
V R
VR
D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D004804:Eosinophils / Q000276:immunology*; D005243:Feces / Q000469:parasitology; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007958:Leukocyte Count; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000469:parasitology; D008297:Male; D009349:Nematode Infections / Q000150:complications / Q000469:parasitology; D010270:Parasite Egg Count; D010963:Plasmodium falciparum / Q000276:immunology / Q000302:isolation & purification; D012189:Retrospective Studies
D000962:Antimalarials; D006454:Hemoglobins