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Immunopathological changes in kidney in Plasmodium falciparum malaria
Abstract:
Fifteen (34.8%) of 43 patients of falciparum malaria screened for urinary abnormalities showed significant proteinuria (greater than 150 mg/24 h), haematuria (greater than 1/HPF) and casts, with or without azotaemia. Light microscopic examination of renal biopsy tissue from 12 patients revealed mesangial and endothelial proliferative change in 8, and acute tubular necrosis in one patient. Immunofluorescence showed IgM alone, or IgG and IgM along with C3, in 7 patients within the mesangium or along the capillary walls. Repeat kidney biopsy after 6 wk in 5 patients revealed no residual pathology indicating the reversible nature of the lesions.
Insights
Falciparum malaria can cause significant kidney damage, including proteinuria and haematuria. Renal biopsies reveal reversible inflammatory and cellular changes, indicating the kidney
Area of Science:
- Nephrology
- Infectious Diseases
- Pathology
Background:
- Falciparum malaria is a significant global health concern.
- Renal abnormalities are a known complication of falciparum malaria.
Purpose of the Study:
- To investigate the spectrum of urinary and renal histopathological changes in patients with falciparum malaria.
- To assess the reversibility of kidney lesions in falciparum malaria.
Main Methods:
- Screening of 43 patients with falciparum malaria for urinary abnormalities.
- Light microscopy and immunofluorescence of renal biopsy tissue from 12 patients.
- Repeat kidney biopsy after 6 weeks in 5 patients.
Main Results:
- 34.8% of patients exhibited significant proteinuria, haematuria, and casts.
- Renal biopsies showed mesangial/endothelial proliferative changes or acute tubular necrosis.
- Immunofluorescence revealed immune complex deposition (IgM, IgG, C3) in 7 patients.
- Repeat biopsies demonstrated resolution of lesions, indicating reversibility.
Conclusions:
- Falciparum malaria frequently causes significant, yet reversible, renal pathology.
- Immune complex deposition plays a role in malaria-associated glomerulopathy.
- Prompt diagnosis and management are crucial for preventing long-term kidney damage.