Hemoglobin Concentration and Parasitemia on Hospital Admission Predict Risk of Multiple Organ Dysfunction Syndrome among Adults with Malaria

Walton, Emily T.; Oliveros, Henry; Villamor, Eduardo

doi:10.4269/ajtmh.13-0640

Cited by 5 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Glucocorticoids are considered to be the most effective anti-inflammatory drugs (21), but their therapeutic role in sepsis remains controversial, particularly regarding the proper dose of them. A large number of clinical studies have determined that the concentration of inflammatory factors in low in the blood of sepsis patients receiving hydrocortisone (22,23). Furthermore, glucocorticoids are immunosuppressive agents, and different degrees of immune function inhibition may occur in the course of application.…”

Section: Discussionmentioning

confidence: 99%

Protective effects of glucocorticoid on liver injury in a rat sepsis model

Liu

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

Sepsis is one of the leading causes of death with unsatisfactory current treatments. The present study assessed the liver protective effect of glucocorticoids on different levels of inflammation in septic shock rats. A rat septic shock model was established by lipopolysaccharide (LPS) injection. Rats were divided into control (Control), high-inflammation treated with hydrocortisone (HT), high-inflammation non-treatment (HNT), low-inflammation treated with hydrocortisone (LT) and low-inflammation non-treatment (LNT) groups according to the levels of serum C-reactive protein (CRP), interleukin (IL)-6 and interferon (IFN)-γ. The mean arterial pressure and heart rate changes were continuously monitored and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured by an automatic biochemical analyzer. Hematoxylin and eosin (H&E) staining was performed to observe the pathological changes of liver tissue. Western blot analysis was used to detect the expression of p38 mitogen-activated protein kinase (MAPK) and NF-κB protein. The results demonstrated that following 7 days of treatment, there were no obvious differences in the serum CRP, IL-6 and IFN-γ levels between the HT group and the control group, whilst the HNT group, LT group and LNT group were significantly different compared with the HT and control groups. H&E staining demonstrated that the liver cells in the HT group were homogeneous following 7 days of treatment. Western blot analysis determined that the phosphorylation levels of p38MAPK and NF-κB in HT group were reduced significantly compared with the LT group, while there was no obvious difference with the control group after 7 days treatment. The present results indicated that glucocorticoids have better therapeutic effect on septic shock rats with high-inflammation compared with low-inflammation rats. The present study provides a novel approach for glucocorticoid treatment of septic shock.

show abstract

Section: Discussionmentioning

confidence: 99%

Protective effects of glucocorticoid on liver injury in a rat sepsis model

Liu

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…There is a need to predict the complications in the stable pretreatment stage. A retrospective study of patients admitted for malaria showed that hemoglobin and parasitemia at admission predicted subsequent multiple organ dysfunction syndrome (MODS); however, the study did not exclude complicated cases at admission [13]. Intra-neutrophilic pigments correlate well with parasitemia and severity of complications, but the utility of this finding has not been studied in an uncomplicated pretreatment setting.…”

Section: Introductionmentioning

confidence: 98%

Pretreatment elevated erythrocyte sedimentation rate and C-reactive protein as a predictor of malarial complications

Vemula

Vidyalakshmi

Unnikrishnan

et al. 2016

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Complications of malaria can develop suddenly and unexpectedly. Although various parameters have been associated with severity of malaria, they have not been studied as predictors of these events. Many of the malarial complications are inflammatory in nature, and C-reactive protein (CRP) and elevated erythrocyte sedimentation rate (ESR) could be early markers of these complications and might precede and predict the development of complications. Methodology: A total of 122 inpatients with uncomplicated newly diagnosed malaria were studied. CRP, ESR, hemoglobin, and platelets were measured before initiating treatment. Patients were monitored closely for the subsequent development of complications based on the World Health Organization's definition of severe malaria. Results: Seven patients (5.7%) had worsening of symptoms compared to the day of admission and had higher pretreatment CRP and increased ESR compared to those patients who did not develop complications. Area under receiver operator characteristic curve was 0.761(p=0.02) for CRP and 0.739 (p = 0.035) for ESR. CRP>124 mg/L and increased ESR (>34.5 mm in the first hour) had a sensitivity of 71.4% and specificity of 79.1%, respectively, for predicting complications of malaria. Other parameters did not reach statistical significance for predicting complications. Elevated CRP and elevated ESR had a negative predictive value of 97.8%. Conclusions: Elevated CRP>124mg/L and increased ESR>34.5 mm in the first hour at the time of diagnosis in patients with uncomplicated malaria identifies patients who might subsequently develop complications of malaria.

show abstract

“…Asexual reproduction of Plasmodium falciparum occurs mainly in the erythrocytes. The high density of Plasmodium in severe malaria patients can lead to multiple organ dysfunction [ 3 ]. In this study, 12 patients who met the diagnostic criteria for severe malaria [ 4 ] were treated with exchange transfusion 14 times, as well as a conventional anti-malarial treatment.…”

Section: Introductionmentioning

confidence: 99%

Manual exchange transfusion for severe imported falciparum malaria: a retrospective study

Lin

Huang

Qin

et al. 2018

Malar J

View full text Add to dashboard Cite

BackgroundThis study was designed to evaluate the efficacy of exchange transfusion in patients with severe imported falciparum malaria. Twelve patients who met the diagnostic criteria for severe malaria were treated with exchange transfusion 14 times according to a conventional anti-malarial treatment. This study evaluated the efficacy of exchange transfusion for severe imported falciparum malaria.MethodsClinical data of severe imported falciparum malaria patients admitted to the intensive care unit (ICU) of Nantong Third People’s Hospital from January 2007 to December 2016 were investigated in this retrospective study. Patients were divided into the intervention group, which received exchange transfusion, and the control group. This study assessed parasite clearance and outcomes of the two groups, and levels of erythrocytes, haemoglobin, platelets, coagulation, liver function, lactate, C-reactive protein, and procalcitonin, before and after exchange transfusion in the intervention group.ResultsThere was no significant difference in the severity of admitted patients. Exchange transfusion was successfully applied 14 times in the intervention group. Differences in the levels of erythrocytes, haemoglobin and platelets did not reach statistical significance. Exchange transfusion improved coagulation, liver function, lactic acid, C-reactive protein, and procalcitonin. No differences were observed in parasite clearance, ICU and hospital length of stay, in-hospital mortality, and costs of hospitalization between the two groups.ConclusionExchange transfusion as adjunctive therapy for severe malaria was observed to be safe in this setting. Exchange transfusion can improve liver function and coagulation and reduce inflammation, but it failed to improve parasite clearance and the outcomes of severe imported falciparum malaria in this case series.

show abstract

Hemoglobin Concentration and Parasitemia on Hospital Admission Predict Risk of Multiple Organ Dysfunction Syndrome among Adults with Malaria

Cited by 5 publications

References 17 publications

Protective effects of glucocorticoid on liver injury in a rat sepsis model

Protective effects of glucocorticoid on liver injury in a rat sepsis model

Pretreatment elevated erythrocyte sedimentation rate and C-reactive protein as a predictor of malarial complications

Manual exchange transfusion for severe imported falciparum malaria: a retrospective study

Contact Info

Product

Resources

About