Differential sequestration of parasitized erythrocytes in the cerebrum and cerebellum in human cerebral malaria

Kyaw Sein Kyaw Kyaw Sein, Y. Maeno, Van Thuc Hoang Van Thuc, Kim Anh Trinh Kim Anh, M. Aikawa

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Sequestration of parasitized red blood cells (PRBC) in the microvessels results in impairment of microcirculation with organ dysfunction in complicated human Plasmodium falciparum malaria. In cerebral malaria patients, the percentage of small blood vessels with PRBC sequestration is higher in the brain than in other organs. The clinical severity of cerebral malaria depends on the level of PRBC sequestration in the brain. In our study, postmortem samples from cerebrum and cerebellum of 16 patients who died of P. falciparum malaria were examined and compared using light microscopy. In the cerebellum, the percentage of microvessels with PRBC sequestration was higher than that in the cerebrum. The difference in sequestration rates between cerebrum and cerebellum is statistically significant (P < 0.05). There is a higher degree of vascularity in the cerebellum (7 vessels/mm2) than in the cerebrum (5 vessels/mm2), and the difference is also statistically significant (P < 0.025). Perivascular hemorrhages also occur more frequently in the cerebellum than in the cerebrum. The results of this study, which show that differential sequestration of PRBC occurs in the microvessels of the cerebrum and cerebellum, explain the varied neurologic manifestations that result from cerebral and cerebellar dysfunction in human cerebral malaria. This study also reveals the necessity of postmortem histologic examination of the cerebellum in every suspected case of cerebral malaria.

Original languageEnglish
Pages (from-to)504-511
Number of pages8
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume48
Issue number4
Publication statusPublished - 01-01-1993

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Cerebral Malaria
Cerebrum
Cerebellum
Erythrocytes
Microvessels
Falciparum Malaria
Cerebellar Diseases
Brain
Microcirculation
Neurologic Manifestations
Blood Vessels
Microscopy
Autopsy
Hemorrhage
Light

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

Kyaw Kyaw Sein, Kyaw Sein ; Maeno, Y. ; Hoang Van Thuc, Van Thuc ; Trinh Kim Anh, Kim Anh ; Aikawa, M. / Differential sequestration of parasitized erythrocytes in the cerebrum and cerebellum in human cerebral malaria. In: American Journal of Tropical Medicine and Hygiene. 1993 ; Vol. 48, No. 4. pp. 504-511.
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Differential sequestration of parasitized erythrocytes in the cerebrum and cerebellum in human cerebral malaria. / Kyaw Kyaw Sein, Kyaw Sein; Maeno, Y.; Hoang Van Thuc, Van Thuc; Trinh Kim Anh, Kim Anh; Aikawa, M.

In: American Journal of Tropical Medicine and Hygiene, Vol. 48, No. 4, 01.01.1993, p. 504-511.

Research output: Contribution to journalArticle

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