ArticleAmerican journal of hematology2024
Retention of uninfected red blood cells causing congestive splenomegaly is the major mechanism of anemia in malaria.
Article in American journal of hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 25 citations in OpenAlex.
- The LEF1-LAG3 axis regulates CD4Parasites & vectors · 2026Article
- Chronic Malaria Is Associated With Trauma-related Splenic Rupture Requiring Splenectomy.The Journal of infectious diseases · 2026Article
- The role of the spleen in red blood cell loss caused by malaria: A mathematical model.PLoS computational biology · 2026Article
- Splenic accumulation of intact Plasmodium ovale sensu lato-infected red blood cells in a patient presenting with splenic rupture.PLoS neglected tropical diseases · 2026Article
- Plasmodium falciparum gene expression signatures and antibody profiling implicate the fikk, phist, and surf multigene families in severe malaria syndromes.The Journal of infection · 2025Article
- Systems approach identifies monocyte imbalance in symptomatic and asymptomatic P. vivax malaria.Molecular systems biology · 2025Article
- NFATc1 regulates LAG3+CD8+ T cells in the spleen of mice infected with Plasmodium yoelii NSM.PLoS neglected tropical diseases · 2025Article
- Clinical Findings in Migrants With AsymptomaticOpen forum infectious diseases · 2025Article
- Reduced Red Blood Cell Deformability in Vivax Malaria.The Journal of infectious diseases · 2025Article
- Hematopoietic effects of Fufang E'jiao Jiang revealed by microbiome, metabolome and transcriptome analyses: a multi-omics strategy.Frontiers in immunology · 2025Article
- Clearance of pathogenic erythrocytes is maintained despite spleen dysfunction in children with sickle cell disease.American journal of hematology · 2024Article
- Article
- Retention of uninfected red blood cells causing congestive splenomegaly is the major mechanism of anemia in malaria.American journal of hematology · 2024Article
- Immunoregulation role of the erythroid cells.Frontiers in immunology · 2024Review
- Article
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Authors and funding
29 authors at 8 institutions in 5 countries.
Funding
Abstract
Splenomegaly frequently occurs in patients with Plasmodium falciparum (Pf) or P. vivax (Pv) malarial anemia, but mechanisms underlying this co-occurrence are unclear. In malaria-endemic Papua, Indonesia, we prospectively analyzed red blood cell (RBC) concentrations in the spleen and spleen-mimetic retention in 37 subjects splenectomized for trauma or hyperreactive splenomegaly, most of whom were infected with Plasmodium. Splenomegaly (median 357 g [range: 80-1918 g]) was correlated positively with the proportion of red-pulp on histological sections (median 88.1% [range: 74%-99.4%]; r = .59, p = .0003) and correlated negatively with the proportion of white-pulp (median 8.3% [range: 0.4%-22.9%]; r = -.50, p = .002). The number of RBC per microscopic field (>95% uninfected) was correlated positively with spleen weight in both Pf-infected (r = .73; p = .017) and Pv-infected spleens (r = .94; p = .006). The median estimated proportion of total-body RBCs retained in Pf-infected spleens was 8.2% (range: 1.0%-33.6%), significantly higher than in Pv-infected (2.6% [range: 0.6%-23.8%]; p = .015) and PCR-negative subjects (2.5% [range: 1.0%-3.3%]; p = .006). Retained RBCs accounted for over half of circulating RBC loss seen in Pf infections. The proportion of total-body RBC retained in Pf- and Pv-infected spleens correlated negatively with hemoglobin concentrations (r = -.56, p = .0003), hematocrit (r = -.58, p = .0002), and circulating RBC counts (r = -.56, p = .0003). Splenic CD71-positive reticulocyte concentrations correlated with spleen weight in Pf (r = 1.0; p = .003). Retention rates of peripheral and splenic RBCs were correlated negatively with circulating RBC counts (r = -.69, p = .07 and r = -.83, p = .008, respectively). In conclusion, retention of mostly uninfected RBC in the spleen, leading to marked congestion of the red-pulp, was associated with splenomegaly and is the major mechanism of anemia in subjects infected with Plasmodium, particularly Pf.
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