TY - JOUR ID - 46972 TI - Plasmodium Vivax Malaria: Usual Illness with Dysregulated Immune Profile JO - Iranian Journal of Immunology JA - IJI LA - en SN - 1735-1383 AU - Gupta, Richa AU - Dixit, Sonali AU - Garg, Neha AU - Kotru, Mrinalini AD - University College of Medical Sciences and GTB Hospital AD - Senior Resident , Department of Pathology, UCMS and GTBH, delhi AD - department of pathology, UCMS and GTBH, Delhi, India AD - Professor, Department of pathology, UCMS and GTBH, Delhi, India Y1 - 2020 PY - 2020 VL - 17 IS - 3 SP - 250 EP - 254 KW - Afebrile KW - Immune thrombocytopenia KW - Plasmodium Vivax Malaria DO - 10.22034/iji.2020.85891.1729 N2 - Afebrile Plasmodium vivax disease is believed to be extremely rare; and so is the association of a secondary immune thrombocytopenia due to Plasmodiun vivax malaria. This is a case of malaria presenting in an atypical manner. A middle aged male (31 years) came with occasional bleeding around gums, small petechial haemorrhages over chest and abdomen, and blood in stools for a few months, but no fever. In addition, the cervical lymph nodes were slightly enlarged. Spleen was 3 cm below costal margin. Platelets were found to have markedly decreased with clusters of megakaryocytes in the bone marrow. A possibility of Immune thrombocytopenic purpura was considered and immunoglobulin started intravenously, however platelet counts remained low. Later, in a follow up smear, trophozoites of P. vivax were discovered. Antimalarial drugs (Artesunate) were administrated for the patient along with IV immunoglobulins, to which he responded. It was revealed by flow cytometry that the ratio of helper to cytotoxic cells was reversed (0.9). This highlighted a rare case of afebrile malaria in association with immune dysregulation. Accordingly, malaria, though uncommon, could trigger immune thrombocytopenia. UR - https://iji.sums.ac.ir/article_46972.html L1 - https://iji.sums.ac.ir/article_46972_28135f9785222bc63c6b38ce0345991a.pdf ER -