Alteration of platelet counts and lipid profiles after treatment of acute Plasmodium vivax.
During malaria infections, thrombocytopenia and low cholesterol levels are frequently observed changes. We compared these changes in patients admitted with fevers and infected with Plasmodium vivax, patients admitted with fevers with respiratory/urinary infections and afebrile normal (control) non-infected volunteers. Changes in the platelet count and lipid parameters are reported for malaria patients after treatment with hydroxychloroquine and primaquine for acute P. vivax malaria. Of a total 141 participants, 55 patients were diagnosed with malaria (positive blood smear) prior to treatment. Compared to the normal (n=52) and non-malaria fever groups (n=34), there was a significant decrease in five hematologic indices (white blood cell, red blood cell, hemoglobin, hematocrit and platelet) and three lipid parameters (total cholesterol, HDL-c and LDL-c) in the vivax malaria group at day 0 (pre-treatment). Following treatment, the platelet counts returned to normal limits (P<0.05) from 91,058/microL on day 0 to 246,833/microL by day 17 after treatment. However, changes in the lipid parameters of malaria patients showed a slow recovery to normal limits compared to the platelet counts. The HDL-c and LDL-c remained low for 1 month after treatment but increased at 3 and 6 months post-treatment. At 12 months after treatment, the levels of two lipid parameters had fully recovered to the normal limits. Thus, special attention should be applied when interpreting laboratory blood profiles of malaria patients, especially platelet and lipid based tests, until full recovery after treatment.
Kim
Jang Su
JS
Department of Laboratory Medicine, Brain Korea 21 Graduate School of Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
Oh
Jun Seo
JS
Chang
Eun-Ah
EA
Bae
Sook Young
SY
Nam
Deok Hwa
DH
Lee
Chang Hwan
CH
Yang
Ji Hyun
JH
Lee
Chang Kyu
CK
Lee
Won Ja
WJ
Kim
Heung Chul
HC
Klein
Terry A
TA
Lim
Chae Seung
CS
Kim
Young Kee
YK
D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011319:Primaquine / Q000627:therapeutic use*; D013997:Time Factors
D000962:Antimalarials; D008055:Lipids; D006886:Hydroxychloroquine; D011319:Primaquine