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Malarial hepatitis.

D K Kochar1, P Singh, Priya Agarwal

  • 1Department of Gastroenterology, SP Medical College, Bikaner 334001.

The Journal of the Association of Physicians of India
|July 21, 2004
PubMed
Summary
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Plasmodium falciparum malaria with jaundice causes significant liver damage, indicated by clinical, biochemical, and histopathological changes. These findings support the term "malarial hepatitis" due to observed hepatocellular dysfunction.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pathology

Background:

  • Plasmodium falciparum malaria can present with jaundice, suggesting potential liver involvement.
  • Understanding the spectrum of liver damage in malaria is crucial for effective patient management.

Purpose of the Study:

  • To investigate the clinical, biochemical, and histopathological liver changes in patients with Plasmodium falciparum malaria and jaundice.
  • To evaluate the extent of hepatocellular dysfunction in these patients.

Main Methods:

  • A study of 50 patients with Plasmodium falciparum malaria and jaundice was conducted.
  • Liver function tests and histopathological examination of liver biopsies (in 20 patients) were performed.
  • Patients were treated with quinine.

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Main Results:

  • Jaundice was present in all patients, with varying degrees of hyperbilirubinemia.
  • Histopathological findings included swollen hepatocytes, pigment deposition, inflammation, congestion, and centrizonal necrosis.
  • Elevated AST and ALT levels were observed, alongside conjugated hyperbilirubinemia.

Conclusions:

  • Significant hepatocellular dysfunction occurs in Plasmodium falciparum malaria with jaundice.
  • Histopathological evidence supports the concept of 'malarial hepatitis' as a distinct clinical entity.