Platelet-induced autoagglutination of Plasmodium falciparum-infected red blood cells and disease severity in Thailand.
Chotivanich K., Sritabal J., Udomsangpetch R., Newton P., Stepniewska KA., Ruangveerayuth R., Looareesuwan S., Roberts DJ., White NJ.
The relationship of the platelet-mediated autoagglutination of Plasmodium falciparum-infected red blood cells (IRBCs) to disease severity was investigated in 182 Thai patients with falciparum malaria; it was evident in 43% of uncomplicated malaria (n=63), 41% of severe malaria (n=104), and 100% of cerebral malaria (n=15; P=.001) isolates. The median (range) number of IRBCs in agglutinates per 1000 IRBCs was significantly higher in cerebral malaria (6 [3-42]) than in severe (0 [0-52]) and uncomplicated (0 [0-24]) malaria (P=.01). In multivariate analyses, high parasitemia and cerebral malaria were associated independently with parasite agglutination.