BACKGROUND: The immunologial alterations of tertian malaria are poorly understood. We investigated the hematological and immunological findings to know immunological mechanism of tertian malaria. METHODS: Forty patients with tertian malaria, hospitalized in the three affiliated hospitals of Catholic University Medical College, were enrolled in this study. The hematologic examination was performed by Coulter STKS. Atypical lymphocytes, eosinophils and plasmodium burden were counted manually. The immunoglobulin and complement concentrations were measured by nephelometry( Behring nephelometer analyzer, Germany) and automated chemiluminescence system(ACS 180, USA). The peripheral blood lymphocyte subsets were analyzed by flow cytometry using anti- CD3, CD4, CD8, CD19, CD25 and CD56 monoclonal antibodies(Becton Dickinson, San Jose, USA) and negative control. RESULTS: Anemia, lymphopenia, thrombocytopenia and eosinopenia were observed, and the eosinophil count was correlated to platelet count. The numbers of CD3+, CD8+, CD19+, CD56+, CD3-/CD56+ and CD8+/CD56+ lymphocytes were lower in tertian malaria than in control group(P<0.05). At 8th week after treatment, the percentage of CD8+ lymphocytes became significantly higher than before. The percentage of CD19+ lymphocytes was correlated to the number of eosinophils and thrombocytes(r=0.641, 0.417, P=0.000, 0.006). The serum concentrations of IgM and IgE were higher in tertian malaria than in control group. At 1st week after treatment, the IgE concentration became significantly lower than acute stage(P=0.014). The C3 and C4 concentrations were higher in tertian malaria than in control group. The C4 concentration became the same to the control group at the first week after treatment and was correlated to hemoglobin concentration. CONCLUSIONS: The eosinopenia with high IgE concentration could be a valuable marker of tertian malaria and IgE and C4 concentrations could be useful for serial monitoring after treatment.
Anemia ; Complement System Proteins ; Eosinophils ; Flow Cytometry ; Humans ; Immunoglobulin E ; Immunoglobulin M ; Immunoglobulins ; Korea* ; Luminescence ; Lymphocyte Subsets ; Lymphocytes ; Lymphopenia ; Malaria* ; Plasmodium ; Plasmodium vivax ; Platelet Count ; Thrombocytopenia

Purpose: The purpose of the study was to validate the Korean version of Patient-Reported Outcomes Measurement Information System 29 Profile v2.1 (K-PROMIS-29 V2.1) among cancer survivors. Materials and Methods: Participants were recruited from outpatient clinics of the Comprehensive Cancer Center at the Samsung Medical Center in Seoul, South Korea, from September to October 2018. Participants completed a survey questionnaire that included the K-PROMIS-29 V2.1 and the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30). Principal component analysis and confirmatory factor analysis (CFA) and Pearson’s correlations were used to evaluate the reliability and validity of the K-PROMIS-29 V2.1. Results: The mean age of the study participants was 54.4 years, the mean time since diagnosis was 1.2 (±2.4) years, and 349 (87.3%) completed the entire questionnaire. The Cronbach’s alpha coefficients of the seven domains in the K-PROMIS-29 V2.1 ranged from 0.81 to 0.96, indicating satisfactory internal consistency. In the CFA, the goodness-of-fit indices for the K-PROMIS-29 V2.1 were high (comparative fit index, 0.91 and standardized root-mean-squared residual, 0.06). High to moderate correlations were found between comparable subscales of the K-PROMIS-29 V2.1 and subscales of the EORTC QLQ-C30 (r=0.52-0.73). Conclusion The K-PROMIS-29 V2.1 is a reliable and valid measure for assessing the health-related quality of life domains in a cancer population, thus supporting their use in studies and oncology trials.