Malaria N° 6 - Subject N°6

MALARIA AND THROMBOCYTOPENIA
P. Bourée & A. Torossian

SUMMARY
The malaria induced thrombocytopenia is a frequent and mostly benign phenomena. 242 cases of malaria were studied, with different criteria, such as the age, the place of infection, the Plasmodium species, the parasitaemia, and the clinical and biological symptomes (leukocytosis, hemoglobin). 57,8% of them had a thrombocytopenia on admission, with an average platelet count of 83 315/mm3, which had increased to 223136/mm3 after 8 days of treatment. No evidence of haemorrhagic manifestation has been reported among the 24 cases presenting a platelets count below 50000/mm3. Only one patient had a purpura (with 118000 platelets/mm3). No correlation was noticed with sex, age, Plasmodium species, chemoprophylaxis. A positive statistical correlation could be found between the thrombocytopenia and some factors, such as fever above 39°C (p = 10-8), high transaminases rate (p < 10-5), european travellers in tropical areas (p < 0,01) ; and high level of parasitaemia (p = 0,01). Its occurrence process is still not perfectly known, involving most probably some autoimmune and biochemical factors, while hypothesis of disseminated intravascular coagulation of hypersplenism is currently put aside.

KEY-WORDS: Platelets, Thrombocytopenia, Malaria, ADP