Liver function abnormalities in falciparum malaria

Abstract

Background: Malaria still continues to be a major killer of mankind especially in developing countries. Almost all deaths and severe disease are due to Plasmodium falciparum. It is observed that the patients of falciparum malaria with liver function abnormalities are more vulnerable to the development of complications like cerebral malaria, anemia, renal failure, acute respiratory distress syndrome, etc.

Methods: 50 cases of Plasmodium falciparum malaria diagnosed by peripheral smear examination or by immuno-chromatographic test - falci check, pan malaria or by rapid optimal test were included in the study. All these patients were subjected to blood investigations like hemoglobin level, total leukocyte count, differential count, renal function tests, liver function tests and random blood sugar.

Results: Serum bilirubin level was raised in 66% of cases with 28% of cases showing levels above 3.0g/dL. Patients with clinical jaundice showed mean 2-3 fold raise in AST levels along with ALT levels. 64% of cases had normal ALK levels. Serum proteins found to be normal in 92% of cases.

Conclusions: Deranged liver functions are commonly seen as a complication of severe malarial infection. Presence of raised hepatic enzymes with near normal coagulation parameters, in presence of documented malarial infection should suggest presence of malarial hepatopathy.