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Hepatic changes in fatal malaria: an emerging problem.

A B Rupani¹, A D Amarapurkar

¹Third Floor, College Building, Department of Pathology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, A. L. Nair Road, Mumbai Central, Mumbai - 400 008, India. asharupani@yahoo.com

Annals of Tropical Medicine and Parasitology

|February 12, 2009

Summary

This summary is machine-generated.

Fatal malaria in India shows rising urban incidence. Histopathology reveals Kupffer-cell hyperplasia, malarial pigment, and liver necrosis, often mimicking viral hepatitis due to jaundice.

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Area of Science:

Pathology
Tropical Medicine
Hepatology

Background:

Fatal malaria incidence is increasing in Indian urban areas.
Jaundice in malaria cases can lead to misdiagnosis as viral hepatitis.
Autopsy-based studies are crucial for understanding fatal malaria pathology.

Purpose of the Study:

To investigate the histopathological changes in the livers of fatal malaria cases in India.
To compare liver histology in fatal malaria with viral hepatitis and control groups.
To identify characteristic features of fatal malaria in liver tissue.

Main Methods:

Retrospective autopsy-based study of 151 fatal malaria cases.
Histological examination of liver samples stained with Prussian Blue to identify malarial pigment.
Comparison of liver histology with 11 viral hepatitis cases and 50 controls.

Main Results:

Kupffer-cell hyperplasia and haemozoin pigment retention were common in fatal malaria livers.
Liver necrosis observed in 41% of cases, with 10% showing centrilobular haemorrhagic necrosis.
Inflammation was sparse compared to viral hepatitis, but mixed portal inflammation was noted in malaria cases.

Conclusions:

Jaundice is a common clinical presentation in fatal malaria, potentially mimicking viral hepatitis.
Key histopathological findings include Kupffer-cell hyperplasia, malarial pigment, and liver cell necrosis.
Additional features like portal inflammation, steatosis, and cholestasis can also be present in fatal malaria livers.