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Hepatic changes in P. falciparum malaria.

S K Mishra1, S Mohanty, B S Das

  • 1Department of Internal Medicine, Ispat General Hospital Rourkela, India.

Indian Journal of Malariology
|September 1, 1992
PubMed
Summary

Complicated malaria, caused by Plasmodium falciparum, can lead to mild liver enzyme elevations and hepatomegaly. However, severe liver injury like acute hepatitis or necrosis is uncommon in these patients.

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Area of Science:

  • Tropical Medicine
  • Hepatology
  • Infectious Diseases

Background:

  • Plasmodium falciparum malaria is a severe infectious disease.
  • Liver involvement is a known complication of malaria.
  • The spectrum of liver injury in complicated malaria requires further elucidation.

Purpose of the Study:

  • To investigate the frequency and nature of liver dysfunction in hospitalized patients with complicated P. falciparum malaria.
  • To determine the incidence of severe liver injury, such as acute hepatitis and necrosis, in this patient cohort.

Main Methods:

  • Liver function tests (serum bilirubin, ALT, ALP, GGT, total protein, albumin) were analyzed.
  • Histopathological examination of liver tissue was performed in select cases.
  • Clinical data from 165 hospitalized patients with complicated P. falciparum malaria were reviewed.

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Main Results:

  • Elevated serum bilirubin, predominantly unconjugated hyperbilirubinaemia, was observed in 33 patients.
  • Mild to moderate elevations in liver enzymes (ALT, ALP, GGT) were noted in a subset of patients.
  • Liver cell necrosis was rare (one patient), while oedema and mononuclear cell infiltration occurred in two patients. Decreased total protein and albumin indicated an acute phase response.

Conclusions:

  • Hepatomegaly and mild liver enzyme elevations are relatively common in complicated P. falciparum malaria.
  • Severe liver injury, including acute hepatitis and liver cell necrosis, is an uncommon complication of P. falciparum malaria.