Volume 75, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Over the last decade, a number of observations have suggested that platelets may play a role in the pathophysiology of severe malaria. However, somewhat paradoxically, thrombocytopenia is not associated clearly with outcome. We studied the relationship between thrombocytopenia and cytokines in Kenyan children with severe malaria and showed that thrombocytopenia (platelet count < 150 × 10/L) strongly correlates with high levels of interleukin (IL)-10. Several studies have shown that high levels of IL-10 are associated with a favorable outcome in severe malaria. Taken together, these data suggest why thrombocytopenia has a complex relationship with severe disease and suggest one mechanism whereby IL-10 may modify the outcome of severe disease.


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  1. Kelton JG, Keystone J, Moore J, Denomme G, Tozman E, Glynn M, Neame PB, Gauldie J, Jensen J, 1983. Immune-mediated thrombocytopenia of malaria. J Clin Invest 71 : 832–836. [Google Scholar]
  2. Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CR, 2002. Changes in white blood cells and platelets in children with falciparum malaria: Relationship to disease outcome. Br J Haematol 119 : 839–847. [Google Scholar]
  3. Wickramasinghe SN, Abdalla SH, 2000. Blood and bone marrow changes in malaria. Baillieres Best Pract Res Clin Haematol 13 : 277–299. [Google Scholar]
  4. van der Heyde HC, Gramaglia I, Sun G, Woods C, 2005. Platelet depletion by anti-CD41 (alphaIIb) mAb injection early but not late in the course of disease protects against Plasmodium berghei pathogenesis by altering the levels of pathogenic cytokines. Blood 105 : 1956–1963. [Google Scholar]
  5. Grau GE, Mackenzie CD, Carr RA, Redard M, Pizzolato G, Allasia C, Cataldo C, Taylor TE, Molyneux ME, 2003. Platelet accumulation in brain microvessels in fatal pediatric cerebral malaria. J Infect Dis 187 : 461–466. [Google Scholar]
  6. Pain A, Ferguson DJ, Kai O, Urban BC, Lowe B, Marsh K, Roberts DJ, 2001. Platelet-mediated clumping of Plasmodium falciparum-infected erythrocytes is a common adhesive phenotype and is associated with severe malaria. Proc Natl Acad Sci USA 98 : 1805–1810. [Google Scholar]
  7. Newton P, Essien E, White NJ, 2004. Platelets and blood coagulation in human malaria. Abdalla SH, Pavol G, eds. Malaria: A Haematological Perspective. London: Imperial College Press, 249–274.
  8. Kreil A, Wenisch C, Brittenham G, Looareesuwan S, Peck-Radosavljevic M, 2000. Thrombopoietin in Plasmodium falciparum malaria. Br J Haematol 109 : 534–536. [Google Scholar]
  9. Karanikas G, Zedwitz-Liebenstein K, Eidherr H, Schuetz M, Sauerman R, Dudczak R, Winkler S, Pabinger I, Kletter K, 2004. Platelet kinetics and scintigraphic imaging in thrombocytopenic malaria patients. Thromb Haemost 91 : 553–557. [Google Scholar]
  10. Kueh YK, Yeo KL, 1982. Haematological alterations in acute malaria. Scand J Haematol 29 : 147–152. [Google Scholar]
  11. Knuttgen HJ, 1987. The bone marrow of non-immune Europeans in acute malaria infection: A topical review. Ann Trop Med Parasitol 81 : 567–576. [Google Scholar]
  12. Abdalla SH, 1990. Hematopoiesis in human malaria. Blood Cells 16 : 401–416. [Google Scholar]
  13. Tacchini-Cottier F, Vesin C, Redard M, Buurman W, Piguet PF, 1998. Role of TNFR1 and TNFR2 in TNF-induced platelet consumption in mice. J Immunol 160 : 6182–6186. [Google Scholar]
  14. Sosman JA, Verma A, Moss S, Sorokin P, Blend M, Bradlow B, Chachlani N, Cutler D, Sabo R, Nelson M, Bruno E, Gustin D, Viana M, Hoffman R, 2000. Interleukin 10-induced thrombocytopenia in normal healthy adult volunteers: Evidence for decreased platelet production. Br J Haematol 111 : 104–111. [Google Scholar]
  15. Kurtzhals JA, Adabayeri V, Goka BQ, Akanmori BD, Oliver-Commey JO, Nkrumah FK, Behr C, Hviid L, 1998. Low plasma concentrations of interleukin 10 in severe malarial anaemia compared with cerebral and uncomplicated malaria. Lancet 351 : 1768–1772. [Google Scholar]
  16. Snow RW, Omumbo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, Newbold C, Gupta S, Marsh K, 1997. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet 349 : 1650–1654. [Google Scholar]
  17. Scaradavou A, 2002. HIV-related thrombocytopenia. Blood Rev 16 : 73–76. [Google Scholar]
  18. Gerardin P, Rogier C, Ka AS, Jouvencel P, Brousse V, Imbert P, 2002. Prognostic value of thrombocytopenia in African children with falciparum malaria. Am J Trop Med Hyg 66 : 686–691. [Google Scholar]

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  • Received : 02 Mar 2006
  • Accepted : 18 May 2006

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