Hemozoin Induced Anemia and Dyserythropoisis: A Case Report

Malarial anemia involves destruction of parasitized and non-parasitized red blood cells and dyserythropoiesis. Malarial pigment, hemozoin (HZ), is possibly implicated in dyserythropoiesis. It is shown by few authors that HZ-fedmonocytes, and 4-hydroxynonenal generated by various types of phagocytosed cells, inhibit progenitor cells, number, their growth and maturation. A variety of abnormalities in the number, morphology and function of blood and bone marrow cells may be found in Plasmodium falciparum. Severe anemia occurs in children with chronic falciparum malaria and low parasitaemia as well as in patients with complicated acute falciparum malaria with high parasitaemia. It has been proposed that the basis of severe malarial anemia, a major cause of morbidity and mortality in endemic areas, is multifactorial. Inappropriately low reticulocytosis is observed in malaria patients suggesting that insufficient erythropoiesis is a major factor. Plasmodium falciparum malaria on marrow examination showed myeloid hyperplasia, erythroid hyperplasia, megaloblastosis and hypoplasia in different proportions and in peripheral blood examination reveals macrocytosis, polychromasia, schistocytosis and presence of nucleated RBC along with pigment laden monocytes and Macrophages.