Shaikh M.S., Ali B., Janjua M., Akbar A., Haider S.A., Moiz B., Raheem A., Baird J.K., Beg M.A.
Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan; Aga Khan University, Karachi, Pakistan; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
Background: Malaria is a life-threatening, multisystem disease caused by the plasmodial parasite with a global incidence of approximately 229 million annually. The parasites are known to have unique and crucial interactions with various body tissues during its life cycle, notably the liver, spleen, and recent work has shown the bone marrow to be a reservoir of infection. Methods: This study is a case series of patients in whom examination of bone marrow revealed malarial parasites. A retrospective record review of 35 parasite-positive bone marrow specimens examined at Aga Khan University Hospital (AKUH), Karachi, Pakistan, over the years 2007 to 2015 was conducted. Bone marrow aspirates were collected as per International Council for Standardization in Haematology (ICSH) guidelines. Results: The median age of patients was 22 years (range 1–75), and 60 % (n = 21) were male. 22 patients had evidence of Plasmodium falciparum, 12 had evidence of Plasmodium vivax and 1 patient had a mixed infection. Gametocytes and trophozoites were the most common stages identified on both peripheral blood and bone marrow examinations. Indications for bone marrow examination included fever of unknown origin and the workup of cytopenias and malignancies. Conclusions: The incidental finding of Plasmodium in samples of bone marrow suggests the reticuloendothelial system may be regularly harbour these parasites, be the infection acute or chronic in character. © 2021, The Author(s).
Bone marrow; Malaria; Pakistan; Plasmodium; Reticuloendothelial
Publisher: BioMed Central Ltd
Volume 20, Issue 1, Art No 254, Page – , Page Count
Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85107613588&doi=10.1186%2fs12936-021-03792-1&partnerID=40&md5=2a4bfbacd9757328f539cbda7d3554a8
Type: All Open Access, Gold, Green
(2020) World Malaria Report 2020, , World Health Organization, Geneva; Cowman, A.F., Healer, J., Marapana, D., Marsh, K., Malaria: Biology and Disease (2016) Cell, 167, pp. 610-624. , COI: 1:CAS:528:DC%2BC28XhslCrsrnF; Brito, M.A.M., Baro, B., Raiol, T.C., Ayllon-Hermida, A., Safe, I.P., Deroost, K., Morphological and transcriptional changes in human bone marrow during natural Plasmodium vivax malaria infections (2020) J Infect Dis; Kanjee, U., Rangel, G.W., Clark, M.A., Duraisingh, M.T., Molecular and cellular interactions defining the tropism of Plasmodium vivax for reticulocytes (2018) Curr Opin Microbiol, 46, pp. 109-115. , COI: 1:CAS:528:DC%2BC1cXhvFejtL7N; Malleret, B., Li, A., Zhang, R., Tan, K.S.W., Suwanarusk, R., Claser, C., Plasmodium vivax; restricted tropism and rapid remodeling of CD71-positive reticulocytes (2015) Blood, 125, pp. 1314-1324. , COI: 1:CAS:528:DC%2BC2MXjvFagu7c%3D; Gruszczyk, J., Kanjee, U., Chan, L.J., Menant, S., Malleret, B., Lim, N.T.Y., Transferrin receptor 1 is reticulocyte-specific receptor for Plasmodium vivax (2018) Science, 359, pp. 48-55. , COI: 1:CAS:528:DC%2BC1cXjslOrsQ%3D%3D; Obaldia, N., Meibalan, E., As, J.M., Ma, S., Clark, M.A., Mejia, P., Bone marrow is a major reservoir in Plasmodium vivax infection (2018) mBio, 9, pp. e00625-18; White, N.J., Turner, G.D., Day, N.P., Dondorp, A.M., Lethal malaria: Marchiafava and Bignami were right (2013) J Infect Dis, 208, pp. 192-198. , COI: 1:CAS:528:DC%2BC3sXhtVehsrbM; Cuartas, F., Rothenberg, J., Fecci, C., Gutterman, J., Diagnosis of malaria by bone marrow aspiration (1972) South Med J, 65, p. 523; Rumball, C., Parsons-Smith, B., Nancekievill, L., Sternal puncture in the diagnosis of malaria (1943) Lancet, 242, pp. 468-469; Zacharias, F., The diagnostic value of bone-marrow biopsy in malaria caused by Plasmodium falciparum (1949) Ann Trop Med Parasitol, 43, pp. 297-303. , COI: 1:STN:280:DyaG3c%2FhsFaltg%3D%3D; Joice, R., Nilsson, S.K., Montgomery, J., Dankwa, S., Egan, E., Morahan, B., Plasmodium falciparum transmission stages accumulate in the human bone marrow (2014) Sci Transl Med, 6, p. 244re5; Farfour, E., Charlotte, F., Settegrana, C., Miyara, M., Buffet, P., The extravascular compartment of the bone marrow: a niche for Plasmodium falciparum gametocyte maturation? (2012) Malar J, 11, p. 285; Tham, W.-H., Lim, N.T., Weiss, G.E., Lopaticki, S., Ansell, B.R., Bird, M., Plasmodium falciparum adhesins play an essential role in signalling and activation of invasion into human erythrocytes (2015) PLoS Pathog, 11; Aguilar, R., Magallon-Tejada, A., Achtman, A.H., Moraleda, C., Joice, R., Cisteró, P., Molecular evidence for the localization of Plasmodium falciparum immature gametocytes in bone marrow (2014) Blood, 123, pp. 959-966. , COI: 1:CAS:528:DC%2BC2cXjt1alt7Y%3D; Ghosh, K., Ghosh, K., Pathogenesis of anemia in malaria: a concise review (2007) Parasitol Res, 101, pp. 1463-1469; Helleberg, M., Goka, B.Q., Akanmori, B.D., Obeng-Adjei, G., Rodriques, O., Kurtzhals, J.A., Bone marrow suppression and severe anaemia associated with persistent Plasmodium falciparum infection in African children with microscopically undetectable parasitaemia (2005) Malar J, 4, p. 56; Wickramasinghe, S.N., Looareesuwan, S., Nagachinta, B., White, N.J., Dyserythropoiesis and ineffective erythropoiesis in Plasmodium vivax malaria (1989) Br J Haematol, 72, pp. 91-99. , COI: 1:STN:280:DyaL1M3osleiug%3D%3D; Abdalla, S.H., Hematopoiesis in human malaria (1990) Blood Cells, 16, pp. 401-416. , COI: 1:STN:280:DyaK3M%2FnslCltg%3D%3D, PID: 2257320, discussion 17 – 9; Marchiafava, E., Bignami, A., On summer-autumn malarial fevers (1894) Two monographs on malaria and the parasites of malarial fevers, pp. 1-232. , Marchiafava E, (ed), New Sydenham Society, London; Schindler, T., Robaina, T., Sax, J., Bieri, J.R., Mpina, M., Gondwe, L., Molecular monitoring of the diversity of human pathogenic malaria species in blood donations on Bioko Island, Equatorial Guinea (2019) Malar J, 18, p. 9; Tatura, S.N.N., Gunawan, S., Bernadus, J., Sandjoto, S., Plasmodium falciparum found in the bone marrow of a child in Manado City, East Indonesia: A case report (2017) Asian Pac J Trop Med, 10, pp. 1015-1017; Sheikh, N.S., Sheikh, A.S., Hussain, S.I., Sheikh, A.A., Utility of thick smears of bone marrow aspirate in pyrexia of unknown origin (2003) J Coll Physicians Surg Pak, 13, pp. 577-580. , PID: 14588172; Mirdha, B.R., Samantray, J.C., Mishra, B., Xess, I., Bone marrow examination for identifying malaria in fever of unknown origin (1999) J Assoc Physicians India, 47, pp. 177-179. , COI: 1:STN:280:DC%2BD3cvkslOktQ%3D%3D, PID: 10999083; Bain, B.J., Bone marrow trephine biopsy (2001) J Clin Pathol, 54, pp. 737-742. , COI: 1:STN:280:DC%2BD3MrjtVektw%3D%3D; Bain, B.J., Bone marrow aspiration (2001) J Clin Pathol, 54, pp. 657-663. , COI: 1:STN:280:DC%2BD3MvptVCrsQ%3D%3D; Smalley, M.E., Abdalla, S., Brown, J., The distribution of Plasmodium falciparum in the peripheral blood and bone marrow of Gambian children (1981) Trans R Soc Trop Med Hyg, 75, pp. 103-105. , COI: 1:STN:280:DyaL3M3nsF2nsg%3D%3D; Wickramasinghe, S.N., Abdalla, S.H., Blood and bone marrow changes in malaria (2000) Baillieres Best Pract Res Clin Haematol, 13, pp. 277-299. , COI: 1:STN:280:DC%2BD3cvis12qtg%3D%3D; Gandapur, A.S., Malik, S.A., Raziq, F., Bone marrow changes in human malaria: a retrospective study (1997) J Pak Med Assoc, 47, pp. 137-139. , COI: 1:STN:280:DyaK2sznsVWgsg%3D%3D, PID: 9230580; Herekar, F., Iftikhar, S., Nazish, A., Rehman, S., Malaria and the climate in Karachi: An eight year review (2020) Pak J Medl Sci, 36, p. 33; Chen, I., Clarke, S.E., Gosling, R., Hamainza, B., Killeen, G., Magill, A., ”Asymptomatic” malaria: a chronic and debilitating infection that should be treated (2016) PLoS Med, 13; Ehsan, H., Wahab, A., Shafqat, M.A., Sana, M.A., Khalid, F., Abdullah, S.M., A systematic review of transfusion-transmissible infections among blood donors and associated safety challenges in Pakistan (2020) J Blood Med, 11, pp. 405-420; Delgado, J.A., Guillén-Grima, F., Moreno, C., Panizo, C., Pérez-Robles, C., Mata, J.J., A simple flow-cytometry method to evaluate peripheral blood contamination of bone marrow aspirates (2017) J Immunol Methods, 442, pp. 54-58. , COI: 1:CAS:528:DC%2BC2sXislCntg%3D%3D
Indexed by Scopus