Immunological alterations associated with Plasmodium vivaxmalaria in South Korea.

Various haematological and immunological studies on patients infected with Plasmodium vivaxwere undertaken, at diagnosis (day 0), after treatment with chloroquine but during primaquine treatment (day 10) and after all treatment (day 59), in South Korea (where there has been a recent and abrupt increase in the incidence of such infection). The main aims were to gain an understanding of the haemato-immunological alterations of this malarial infection, both before and after treatment, and to identify at least one useful marker for the diagnosis and post-treatment monitoring of P. vivaxmalaria. :Thirty-eight patients with P. vivaxmalaria were compared with 20, apparently healthy controls. At diagnosis, the patients had lymphopenia, marked eosinopenia (the eosinophil count being correlated with the platelet count) and thrombopenia. Cells of most of the lymphocyte subsets investigated [i.e. CD3[sup +] , CD8[sup +] , CD19[sup +] , CD56[sup +] , CD3[sup -] /CD56[sup +] and CD8[sup +] /CD56[sup +] but not CD4 [sup +] , CD3[sup +] /CD56[sup +] or CD25[sup +] ] were significantly less common among the lymphocytes of patients at diagnosis than among those of the controls. After initiating treatment, the numbers of CD19[sup +] lymphocytes gradually increased (to normal values by day 59), whereas those of CD3[sup +] /56[sup +] lymphocytes remained abnormally low throughout the follow-up period. The proportions of lymphocytes identified as CD4[sup +] appeared to be unaffected by treatment. Although serum concentrations of IgE (and, to a lesser extent, IgM) were elevated in the patients at diagnosis, they were subnormal on day 10 post-treatment and normal at the day-59 follow-up. :Serum concentrations of IgG and IgA in the patients were always found to be similar to those in the controls. At diagnosis the serum concentrations of complements C3 and C4 were significantly elevated in the patients. C3 remained at the same high concentration during follow-up but the concentrat... [ABSTRACT FROM AUTHOR]