Association of hepatomegaly and jaundice with acute renal failure but not with cerebral malaria in severe falciparum malaria in Thailand.

Treeprasertsuk, Sombat; Singhasivanon, Pratap; Silachamroon, Udomsak; Vannaphan, Suparp; Wilairatana, Polrat

doi:10.4269/ajtmh.2001.65.828

Cited by 27 publications

(24 citation statements)

References 16 publications

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“…Clinical pathophysiology of MARF is complex and multifactorial, including volume depletion, hypoxia, shock, hyperbilirubinemia, intravascular hemolysis, hyperparasitemia and other factors [11,14,15,147,155]. Unlike cerebral malaria, which is related to cytoadherence and obstruction of intracranial capillaries by schizonts [156], the vessels in the kidneys in MARF were free from parasitic obstruction [14,157]. Renal biopsy revealed acute tubular necrosis, tubulointerstital nephritis and glomerular changes with mesangial proliferation and immune complex deposition.…”

Section: Clinical Findingsmentioning

confidence: 99%

Malaria-induced renal damage: facts and myths

Ehrich

Eke

2007

Pediatr Nephrol

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Malaria infections repeatedly have been reported to induce nephrotic syndrome and acute renal failure. Questions have been raised whether the association of a nephrotic syndrome with quartan malaria was only coincidental, and whether the acute renal failure was a specific or unspecific consequence of Plasmodium falciparum infection. This review attempts to answer questions about "chronic quartan malaria nephropathy" and "acute falciparum malaria nephropathy". The literature review was performed on all publications on kidney involvement in human and experimental malarial infections accessible in PubMed or available at the library of the London School of Hygiene and Tropical Medicine. The association of a nephrotic syndrome with quartan malaria was mostly described before 1975 in children and rarely in adult patients living in areas endemic for Plasmodium malariae. The pooled data on malaria-induced acute renal failure included children and adults acquiring falciparum malaria in endemic areas either as natives or as travellers from non-tropical countries. Non-immunes (not living in endemic areas) had a higher risk of developing acute renal failure than semi-immunes (living in endemic areas). Children with cerebral malaria had a higher rate and more severe course of acute renal failure than children with mild malaria. Today, there is no evidence of a dominant role of steroid-resistant and chronic "malarial glomerulopathies" in children with a nephrotic syndrome in Africa. Acute renal failure was a frequent and serious complication of falciparum malaria in non-immune adults. However, recently it has been reported more often in semi-immune African children with associated morbidity and mortality.

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Section: Clinical Findingsmentioning

confidence: 99%

Malaria-induced renal damage: facts and myths

Ehrich

Eke

2007

Pediatr Nephrol

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“…Also, it is reported that, among patients with ARF, there was also a significantly higher aspartate aminotransferase level than in patients without ARF. 16 As shown in Fig. 1, there may be a relationship between ARF and hepatic dysfunction.…”

Section: Discussionmentioning

confidence: 96%

A female patient with malarial nephropathy

et al. 2004

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Malaria remains one of the world's major health problems, particularly in developing tropical countries. Imported malaria is reportedly increasing in Western countries. Acute renal failure (ARF) is the most common cause of death in severe malaria. We report the case of a 63-year-old female patient with a history of travel to a rural area in South Africa who was in coma and had a high fever on admission. Thirty percent of her erythrocytes were infected with Plasmodium falciparum. She had cerebral malaria, malarial nephropathy, anemia, hepatic dysfunction, and disseminated intravenous coagulation (DIC). Quinine and artesunate treatment decreased the number of parasites in the blood. To manage renal failure, hemodialysis was performed for 11 days. A relationship between ARF and hepatic dysfunction was suggested. This relationship is an indication of the clinical course of the disease. In this article, we discuss the mechanism underlying the development of malarial nephropathy and its management, particularly the usefulness of hemodialysis.

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“…Esta hiperbilirrubinemia es generalmente leve y no produce una ictericia intensa (34). La ictericia es criterio de gravedad palúdica cuando se acompaña de aumento importante de las bilirrubinas y se considera indicador de disfunción de los hepatocitos (6,34) o, también, puede explicarse por retención debida a colestasis intrahepática (35).…”

Section: Hiperparasitemiaunclassified

“…Debido a que la bilirrubina es tóxica para las células tubulares renales, estos pacientes tienen alto riesgo de necrosis tubular, que se favorece en presencia de la hipovolemia y la hipoxia ocasionadas por la obstrucción vascular dada por el secuestro de los glóbulos rojos parasitados; esto lleva a una insuficiencia renal aguda (35). Por esto, en todo paciente palúdico con ictericia debe descartarse la disfunción hepática o renal concomitante (36).…”

Section: Hiperparasitemiaunclassified

Signos de peligro en el paciente con malaria

Tobón

2009

biomedica

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Los signos de peligro son hallazgos clínicos que indican gravedad o que tienen utilidad para el pronóstico de complicación o muerte. En el paciente con malaria, o paludismo, se presentan signos clínicos o parasitológicos que pueden reconocerse fácilmente durante la fase aguda de la enfermedad y son indicadores del inicio de una complicación. Entre los signos de peligro que puede presentar el paciente con malaria se incluyen cambios neurológicos, alteraciones del patrón respiratorio, vómito y diarrea persistentes, ictericia, sangrados, orina oscura, llenado capilar lento, palidez intensa, hiperpirexia, hiperparasitemia y esquizontemia. Su reconocimiento oportuno contribuirá a la disminución de complicaciones y muertes.Palabras clave: malaria, paludismo, signos y síntomas, medicina clínica, examen físico, diagnóstico. Danger signs in the malaria patientDanger signs are clinical indicators of severity and are useful to predict complications or death. In the malaria patient, clinical or parasitological signs can be easily be recognized during the acute phase of the illness that indicate serious complications. Danger signs include neurological change, abnormal breathing pattern, persistent vomiting and diarrhea, jaundice, bleeding, dark urine, delayed capillary refill, intense pallor, hyperpyrexia, hyperparasitemia and schizontemia. Timely recognition of these signs can lead to a decrease in cases with complications and deaths. Los signos y síntomas generales de enfermedad se presentan en el paludismo, o malaria, no complicada con una frecuencia similar a como se presentan en la malaria complicada. Entre estos signos y síntomas están la fiebre, el escalofrío y la sudoración; otros hallazgos con frecuencia variable son la cefalea, el dolor osteo-muscular generalizado, la tos, el vómito y la diarrea (1). Sin embargo, otros signos que se presentan durante el curso de la enfermedad o que son sólo evidentes al momento del diagnóstico, se observan con mayor frecuencia en los casos complicados (1,2) y son indicio de deterioro clínico.Los signos de peligro son hallazgos clínicos o parasitológicos indicadores de gravedad o que tienen utilidad pronóstica de complicación o muerte. Los signos clínicos de peligro se establecen con el examen físico del paciente sin exámenes de laboratorio y pueden ser reconocidos por personal no médico. Los signos parasitológicos pueden ser detectados fácilmente por el microscopista en el examen de gota gruesa. Estos signos, llamados también signos de alerta, indican que el paciente evoluciona hacia enfermedad grave o que la complicación ya está presente, pero su presencia no constituye por sí sola un criterio de complicación (3-6). El tiempo que transcurre entre la aparición de estos signos y la complicación es incierto y, por ello, la presencia de cualquier signo de peligro indica la necesidad de atención médica inmediata y, en algunos casos, de hospitalización, mientras se aclara el estado clínico del paciente porque, además, la posibilidad de complicación está en Biomédica 2009;29:320-9

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Association of hepatomegaly and jaundice with acute renal failure but not with cerebral malaria in severe falciparum malaria in Thailand.

Cited by 27 publications

References 16 publications

Malaria-induced renal damage: facts and myths

Malaria-induced renal damage: facts and myths

A female patient with malarial nephropathy

Signos de peligro en el paciente con malaria

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