Sequestration and microvascular congestion are associated with coma in human cerebral malaria.

The pathogenesis of coma in severe Plasmodium falciparum malaria remains poorly understood. Obstruction of the brain microvasculature because of sequestration of parasitized red blood cells (pRBCs) represents one mechanism that could contribute to coma in cerebral malaria. Quantitative postmortem mi...

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Main Authors: Ponsford, M, Medana, I, Prapansilp, P, Hien, T, Lee, S, Dondorp, A, Esiri, M, Day, N, White, N, Turner, G
Format: Journal article
Language:English
Published: 2012
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author Ponsford, M
Medana, I
Prapansilp, P
Hien, T
Lee, S
Dondorp, A
Esiri, M
Day, N
White, N
Turner, G
author_facet Ponsford, M
Medana, I
Prapansilp, P
Hien, T
Lee, S
Dondorp, A
Esiri, M
Day, N
White, N
Turner, G
author_sort Ponsford, M
collection OXFORD
description The pathogenesis of coma in severe Plasmodium falciparum malaria remains poorly understood. Obstruction of the brain microvasculature because of sequestration of parasitized red blood cells (pRBCs) represents one mechanism that could contribute to coma in cerebral malaria. Quantitative postmortem microscopy of brain sections from Vietnamese adults dying of malaria confirmed that sequestration in the cerebral microvasculature was significantly higher in patients with cerebral malaria (CM; n = 21) than in patients with non-CM (n = 23). Sequestration of pRBCs and CM was also significantly associated with increased microvascular congestion by infected and uninfected erythrocytes. Clinicopathological correlation showed that sequestration and congestion were significantly associated with deeper levels of premortem coma and shorter time to death. Microvascular congestion and sequestration were highly correlated as microscopic findings but were independent predictors of a clinical diagnosis of CM. Increased microvascular congestion accompanies coma in CM, associated with parasite sequestration in the cerebral microvasculature.
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spelling oxford-uuid:fe600624-a964-420c-9d7b-ea2c3153e7de2022-03-27T13:35:56ZSequestration and microvascular congestion are associated with coma in human cerebral malaria.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fe600624-a964-420c-9d7b-ea2c3153e7deEnglishSymplectic Elements at Oxford2012Ponsford, MMedana, IPrapansilp, PHien, TLee, SDondorp, AEsiri, MDay, NWhite, NTurner, GThe pathogenesis of coma in severe Plasmodium falciparum malaria remains poorly understood. Obstruction of the brain microvasculature because of sequestration of parasitized red blood cells (pRBCs) represents one mechanism that could contribute to coma in cerebral malaria. Quantitative postmortem microscopy of brain sections from Vietnamese adults dying of malaria confirmed that sequestration in the cerebral microvasculature was significantly higher in patients with cerebral malaria (CM; n = 21) than in patients with non-CM (n = 23). Sequestration of pRBCs and CM was also significantly associated with increased microvascular congestion by infected and uninfected erythrocytes. Clinicopathological correlation showed that sequestration and congestion were significantly associated with deeper levels of premortem coma and shorter time to death. Microvascular congestion and sequestration were highly correlated as microscopic findings but were independent predictors of a clinical diagnosis of CM. Increased microvascular congestion accompanies coma in CM, associated with parasite sequestration in the cerebral microvasculature.
spellingShingle Ponsford, M
Medana, I
Prapansilp, P
Hien, T
Lee, S
Dondorp, A
Esiri, M
Day, N
White, N
Turner, G
Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
title Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
title_full Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
title_fullStr Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
title_full_unstemmed Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
title_short Sequestration and microvascular congestion are associated with coma in human cerebral malaria.
title_sort sequestration and microvascular congestion are associated with coma in human cerebral malaria
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