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Journal of Tropical Pediatrics Advance Access published online on April 28, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp028
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Coagulation Status and Platelet Functions in Children with Severe Falciparum Malaria and their Correlation of Outcome

Rajniti Prasada, B. K. Dasa, Rahul Pengoriaa, Om P. Mishraa, Jyoti Shuklab and Tej B. Singhc

aDepartment of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi
bDepartment of Hematology, Institute of Medical Sciences, Banaras Hindu University, Varanasi
cDepartment of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi

Correspondence: Dr Rajniti Prasad, Senior Lecturer, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India. E-mail <rajnitip{at}gmail.com>.


  Abstract

This study was undertaken to observe the changes in coagulation and platelet profile, and findings were correlated with their outcome. Forty consecutive children with severe falciparum malaria were studied for their coagulation status, i.e. prothrombin time (PT), activated thromboplastin time (APTT), thrombin time (TT) and anti-thrombin-III (AT-III), platelet profile (platelet count, platelet aggregation with adenine diphosphate (ADP) and ADR and PF3 availability). Derangements in the coagulation profile in the form of increased PT, APTT and/or TT were seen in 47.5, 35 and 62.5% cases, respectively, but bleeding was seen in only six cases. Thrombocytopenia was found in 34 patients. Platelet aggregation with ADP and ADR revealed hypoaggregation in 95.3 and 97.5% cases, respectively, and were statistically significant. Platelet factor-3 availability was also significantly prolonged. Patients with prolonged PT, PF-3 and hypoaggregation with adrenaline had 1.4, 1.7 and 1.45 times higher risk of mortality.


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