Association of splenomegaly with cerebral malaria and decreased concentrations of reactive nitrogen intermediates in Thailand.

M Nacher Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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P Singhasivanon Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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S Treeprasertsuk Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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Y Chantachum Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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S Vannaphan Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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B Traore Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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F Gay Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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S Looareesuwan Institut National de la Santé et de la Recherche Médicale Unité 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France. m_nacher@lycos.com

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DOI:
https://doi.org/10.4269/ajtmh.2001.65.639
Volume/Issue:
Volume 65: Issue 5
Page(s):
639–643
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The role of the spleen during Plasmodium falciparum malaria in humans is unclear. In Thailand, malaria transmission is low and splenomegaly is rarer than in high transmission areas. We compared the prevalence of splenomegaly between 52 cerebral malaria patients and 191 patients without complications despite a high parasite biomass. We also measured concentrations of reactive nitrogen intermediates (RNIs) in a fraction of these cases recruited in 1998 (24 cerebral malaria and 56 controls). Splenomegaly was significantly associated with cerebral malaria (adjusted odds ratio = 2.07 [95% confidence interval = 1-4.2]; P = 0.048). There was a linear trend for this association (P = 0.0003). After adjusting for potential confounders, concentrations of RNIs were significantly lower in the presence of splenomegaly (P = 0.01). These results suggest that in humans, as in animal models, the spleen may be involved in the pathogenesis of cerebral malaria. The relationship between RNI concentrations and the spleen suggest that nitric oxide may have a regulating role in the complex physiology of the spleen during malaria.

Published Online:
Nov 2001
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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