The Pathophysiology of Trypanosomiosis Associated Anaemia: A Multifactoral Phenomenon

Abstract

The pathobiology of anaemia in trypanosomiosis remains one of the aspects that still lacks thorough understanding. Extra vascular haemolysis is often identified as a major contributor to anaemia, primarily due to the mononuclear phagocytic activity of the host. This sets off a series of reactions, ultimately resulting in a significant alterations in haemato-biochemical indices. The magnitude of these alterations becomes more pronounced during successive waves of fluctuating parasitemia. However, it's important to note that the basic cause of anaemia is intricate and typically multifaceted, mainly affecting the cellular integrity of red blood cells, terminating into hemolytic anemia and/or increased erythrophagocytosis. Injuries inflicted by the flagella and microtubules of the parasite onto the membranes of erythrocytes further facilitate erythrophagocytosis of damaged RBCs. Additionally, erythrocytes, reticulocytes, and platelets often bind to trypanosomes via. sialic acid receptors, causing injuries to the cells promoting their rupture. A number of factors attributing to haemolytic anaemia include trypanosome are discussed in the present review. This review elaborates on the details and interactions of all these contributing factors