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Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum
BACKGROUND: Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of anaemia, an...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183641/ https://www.ncbi.nlm.nih.gov/pubmed/32334583 http://dx.doi.org/10.1186/s12936-020-03212-w |
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author | Mwaiswelo, Richard O. Mawala, William Iversen, Per O. de Montalembert, Mariane Luzzatto, Lucio Makani, Julie |
author_facet | Mwaiswelo, Richard O. Mawala, William Iversen, Per O. de Montalembert, Mariane Luzzatto, Lucio Makani, Julie |
author_sort | Mwaiswelo, Richard O. |
collection | PubMed |
description | BACKGROUND: Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of anaemia, and contribute to early childhood mortality. CASE PRESENTATION: A 17 year-old Tanzanian male with known SCD was admitted to Muhimbili National Hospital, a tertiary referral centre in Dar-es-Salaam, following an attack of malaria. From 2004 to 2007 the patient had lived in USA, and from 2010 to 2016 in France where, on account of hypersplenism and episodes of splenic sequestrations, in 2014 the spleen was removed. After appropriate clinical and laboratory assessment the patient was re-started on hydroxyurea; and anti-malarial-prophylaxis with proguanil was instituted. The patient has remained well and malaria-free for the following 15 months. CONCLUSION: SCD patients are highly vulnerable to malaria infection, and impaired splenic function is a feature of SCD patients, even in those who still anatomically have a spleen. This patient had a surgical splenectomy and, in addition, had probably lost some of the acquired malaria-immunity by having lived for several years in malaria-free areas. This patient is a compelling reminder that long-term anti-malarial prophylaxis should be offered to all patients with SCD who live in malaria-endemic areas. |
format | Online Article Text |
id | pubmed-7183641 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-71836412020-04-29 Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum Mwaiswelo, Richard O. Mawala, William Iversen, Per O. de Montalembert, Mariane Luzzatto, Lucio Makani, Julie Malar J Case Report BACKGROUND: Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of anaemia, and contribute to early childhood mortality. CASE PRESENTATION: A 17 year-old Tanzanian male with known SCD was admitted to Muhimbili National Hospital, a tertiary referral centre in Dar-es-Salaam, following an attack of malaria. From 2004 to 2007 the patient had lived in USA, and from 2010 to 2016 in France where, on account of hypersplenism and episodes of splenic sequestrations, in 2014 the spleen was removed. After appropriate clinical and laboratory assessment the patient was re-started on hydroxyurea; and anti-malarial-prophylaxis with proguanil was instituted. The patient has remained well and malaria-free for the following 15 months. CONCLUSION: SCD patients are highly vulnerable to malaria infection, and impaired splenic function is a feature of SCD patients, even in those who still anatomically have a spleen. This patient had a surgical splenectomy and, in addition, had probably lost some of the acquired malaria-immunity by having lived for several years in malaria-free areas. This patient is a compelling reminder that long-term anti-malarial prophylaxis should be offered to all patients with SCD who live in malaria-endemic areas. BioMed Central 2020-04-25 /pmc/articles/PMC7183641/ /pubmed/32334583 http://dx.doi.org/10.1186/s12936-020-03212-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Mwaiswelo, Richard O. Mawala, William Iversen, Per O. de Montalembert, Mariane Luzzatto, Lucio Makani, Julie Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
title | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
title_full | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
title_fullStr | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
title_full_unstemmed | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
title_short | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
title_sort | sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from plasmodium falciparum |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183641/ https://www.ncbi.nlm.nih.gov/pubmed/32334583 http://dx.doi.org/10.1186/s12936-020-03212-w |
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