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Case Reports
. 2025 Aug 4:37:e20250409.
doi: 10.62675/2965-2774.20250409. eCollection 2025.

Monitoring of deep lymphocyte phenotypes in the blood and bronchoalveolar lavage fluid of patients with severe malaria-associated acute respiratory distress syndrome

André Miguel Carapinha Gomes  1 , Maria Adão-Serrano  2 , Maria Ribeiro da Cunha  2 , João Santos Silva  2 , Ana Espada de Sousa  1 , João Miguel Ribeiro  2 , Susana Mendes Fernandes  3
Affiliations
Case Reports

Monitoring of deep lymphocyte phenotypes in the blood and bronchoalveolar lavage fluid of patients with severe malaria-associated acute respiratory distress syndrome

André Miguel Carapinha Gomes et al. Crit Care Sci. .

Abstract

Restoring immune homeostasis after an acute insult is essential for achieving a full recovery from an acute respiratory distress syndrome episode. Immune monitoring tools that are not exclusive to the blood compartment are in great demand to help guide treatment decisions. In this longitudinal study, we report a case of severe malaria-associated acute respiratory distress syndrome supported by venovenous extracorporeal membrane oxygenation. Although there was persistent lymphopenia, we observed dynamic shifts in T cells and rare innate lymphoid cell populations. The type 2 immune profile was preponderant at the acute phase, and decreased exhausted T-cell populations indicated recovery. There were significantly different blood and bronchoalveolar lavage fluid profiles. Multiple-compartment immune monitoring is possible and valuable for precise immune modulation.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1. Clinical timepoints and deep immune monitoring during malaria-associated acute respiratory distress syndrome in blood and bronchoalveolar lavage fluid.
See this image and copyright information in PMC

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