[Changes in gastric mucosa in acute malaria]

A high incidence rate of Malaria is observed at Bolívar state (Venezuela) and, beside classic acute symptomatology, we have observed gastric symptoms like epigastralgia, anorexia, nausea and vomits. The scope of this study is to establish changes of gastric mucosa related to Plasmodium infection, using macro and microscopic technics. One hundred both sex patients with Malaria diagnosis done with thick drop technic and gastric symptomatology were studied in our department from March 1990 to February 1991. The esophagus, stomach and duodenum of all patients were evaluated with upper digestive tract endoscopy and still photographs, and biopsies of fundus, body and antrum were taken, fixed in 10% formaldehyde and stained with hematoxylin-eosine method. P. falciparum was found in 52 cases, P. vivax in 39 and 9 infected with both, most of patients complained of shivering fever, epigastralgia (76%), nausea and vomits (72%), tartness (25%) and burning pain (21%). Mucosal edema and congestion (gastritis) were the endoscopic findings in 88% of cases, usually located at antrum (67%) and fundus (33%). The microscopic findings were: mucosal edema (90%), superficial bleeding (87%), microthrombosis (60%), gastric atrophy (40%) and intestinal metaplasia (8%). Acute gastric symptomatology we have observed in patients with acute malaria my be due to microthrombosis and arteriolar occlusion, leading to ischemic changes and mucosal edema. These pathophysiological changes explain most of upper digestive tract symptoms in acute malaria, particularly when agent is P. falciparum. We have not found related papers in bibliography.