THROMBOCYTOPENIA IN FALCIPARUM MALARIA IS ASSOCIATED WITH HIGH CONCENTRATIONS OF IL-10

CLIMENT CASALS-PASCUAL Nuffield Department of Clinical Laboratory Sciences and National Blood Service Oxford Centre, John Radcliffe Hospital, Oxford, United Kingdom; KEMRI Centre for Geographic Medicine Coast, Kilifi, Kenya; Neurosciences Unit, Institute for Child Health, London, United Kingdom

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OSCAR KAI Nuffield Department of Clinical Laboratory Sciences and National Blood Service Oxford Centre, John Radcliffe Hospital, Oxford, United Kingdom; KEMRI Centre for Geographic Medicine Coast, Kilifi, Kenya; Neurosciences Unit, Institute for Child Health, London, United Kingdom

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CHARLES R. J. C. NEWTON Nuffield Department of Clinical Laboratory Sciences and National Blood Service Oxford Centre, John Radcliffe Hospital, Oxford, United Kingdom; KEMRI Centre for Geographic Medicine Coast, Kilifi, Kenya; Neurosciences Unit, Institute for Child Health, London, United Kingdom

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NORBERT PESHU Nuffield Department of Clinical Laboratory Sciences and National Blood Service Oxford Centre, John Radcliffe Hospital, Oxford, United Kingdom; KEMRI Centre for Geographic Medicine Coast, Kilifi, Kenya; Neurosciences Unit, Institute for Child Health, London, United Kingdom

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DAVID J. ROBERTS Nuffield Department of Clinical Laboratory Sciences and National Blood Service Oxford Centre, John Radcliffe Hospital, Oxford, United Kingdom; KEMRI Centre for Geographic Medicine Coast, Kilifi, Kenya; Neurosciences Unit, Institute for Child Health, London, United Kingdom

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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 × 109/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.

Author Notes

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