Liver function abnormalities in falciparum malaria
DOI:
https://doi.org/10.18203/2349-3933.ijam20163498Keywords:
Falciparum malaria, Hepatopathy, Jaundice, Renal failureAbstract
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.
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References
Shukla RP, Pandey AC, Mathur A. Investigation of malaria outbreak in Rajasthan. Indian J Malariol. 1995;32(3):119-128.
Miller LH, Mason SJ, Clyde DF, McGinniss MH. The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy. N Engl J Med. 1976;295(6):302-4.
Bruce Chwatt IJ. Blood transfusion and tropical disease. Trop Dise Bullet. 1972;69:885-62.
Bruce Chwatt IJ. Transfusion Malaria. Bulletin WHO. 1974;50:337-9.
Gopinathan VP, Datta PK, Bhopte AG. Falciparum malaria in north eastern sector. JAPI. 1981;29:1029-35.
Bajiya HN, Kochar DK. Incidence and outcome of neurological sequelae in survivors of cerebral malaria. JAPI. 1996;44(10):679-81.
Chawla LS, Sidhu J, Sabharwal BD. Jaundice in plasmodium falciparum. JAPI. 1989;37(6):390-91.
Mehta SR. Falciparum malaria - 210 cases. JAPI. 1986;34(2):119-20.
Nityanand, Agarwal HK, Kumar P. Hepatic and renal dysfunction in falciparum malaria. JAPI. 1997;45(7):553-4.
Dash SC, Bhryyas VN, Gupta. Falciparum malaria complicating cholestatic jaundice and acute renal failure. JAPI. 1984;42:101-2.
Deb T, Mohanty RK, Ravi K. Atypical presentations of falciparum malaria. JAPI. 1992;40(6):381-4.