Severity of anaemia is associated with bone marrow haemozoin in children exposed to Plasmodium falciparum. (6th January 2014)

• Record Type: Journal Article
• Authors: Aguilar, Ruth; Moraleda, Cinta; Achtman, Ariel H.; Mayor, Alfredo; Quintó, Llorenç; Cisteró, Pau; Nhabomba, Augusto; Macete, Eusebio; Schofield, Louis; Alonso, Pedro L.; Menéndez, Clara
• Is Part Of: British journal of haematology. Volume 164:Number 6(2014:Mar.)
• Page Start: 877
• Page End: 887
• Publication Date: 2014-01-06
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12716
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" id="bjh12716-abs-0001"> <title>Summary</title> <p>There are no large‐scale <italic>ex vivo</italic> studies addressing the contribution of <italic>Plasmodium falciparum</italic> in the bone marrow to anaemia. The presence of malaria parasites and haemozoin were studied in bone marrows from 290 anaemic children attending a rural hospital in Mozambique. Peripheral blood infections were determined by microscopy and polymerase chain reactions. Bone marrow parasitaemia, haemozoin and dyserythropoiesis were microscopically assessed. Forty‐two percent (123/290) of children had parasites in the bone marrow and 49% (111/226) had haemozoin, overlapping with parasitaemia in 83% (92/111) of cases. Sexual and mature asexual parasites were highly prevalent (62% gametocytes, 71% trophozoites, 23% schizonts) suggesting their sequestration in this tissue. Sixteen percent (19/120) of children without peripheral infection had haemozoin in the bone marrow. Haemozoin in the bone marrow was independently associated with decreased Hb concentration (<italic>P</italic> = 0·005) and was more common in dyserythropoietic bone marrows (<italic>P</italic> = 0·010). The results of this <italic>ex vivo</italic> study suggest that haemozoin in the bone marrow has a role in the pathogenesis of malarial‐anaemia through ineffective erythropoiesis. This finding may have clinical implications for the development of drugs targeted to prevent and treat malarial‐anaemia.</p> </abstract>