title: Invasion of erythroblasts by Pasmodium vivax: A new mechanism contributing to malarial anemia.
abstract: Severe malarial anemia causes considerable mortality and morbidity in endemic areas. Possible mechanisms underlying the anemia include lysis of parasitized and nonparasitized red cells as well as parasite product-mediated effects on erythropoiesis. The latter include suppression of erythropoiesis, dyserythropoiesis, and ineffective erythropoiesis. Present transmission electron microscope data in two cases of Pasmodium vivax malaria show a hitherto undescribed mechanism contributing to malarial anemia, namely, infection of erythroblasts by parasites and their subsequent degradation. No parasites were detected in the peripheral blood but parasites were found in the bone marrow. These findings emphasise the value of bone marrow examination in the diagnosis and eradication of malaria.
authors.affiliation: Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China. ruyongxin@126.com
authors.forename: Yong-Xin
authors.initials: YX
authors.lastname: Ru
authors.forename: Bing-Yu
authors.initials: BY
authors.lastname: Mao
authors.forename: Feng-kui
authors.initials: FK
authors.lastname: Zhang
authors.forename: Tian-xiang
authors.initials: TX
authors.lastname: Pang
authors.forename: Shi-xuan
authors.initials: SX
authors.lastname: Zhao
authors.forename: Jin-hua
authors.initials: JH
authors.lastname: Liu
authors.forename: S N
authors.initials: SN
authors.lastname: Wickramasinghe
mesh_terms: D000328:Adult; D000740:Anemia / Q000469:parasitology* / Q000473:pathology; D001854:Bone Marrow Cells / Q000469:parasitology / Q000473:pathology; D004900:Erythroblasts / Q000469:parasitology* / Q000473:pathology; D004920:Erythropoiesis / Q000502:physiology; D005260:Female; D006461:Hemolysis; D006790:Host-Parasite Interactions; D006801:Humans; D008288:Malaria / Q000469:parasitology* / Q000473:pathology; D008297:Male; D010966:Plasmodium vivax / Q000302:isolation & purification / Q000502:physiology* / Q000648:ultrastructure