Hypopituitarism: A rare sequel of cerebral malaria - Presenting as delayed awakening from general anesthesia

Selvaraj, Venkatesh

doi:10.4103/0259-1162.156373

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Authors also suggested that if hypoglycemia was present and/or if cortisol levels were within or below the normal range, stress dose steroids should be considered. Secondary adrenal insufficiency and central hypothyroidism leading to delayed anesthetic recovery have been reported in a patient with history of cerebral malaria [ 9 ]. Another interesting feature described in the literature includes cortisolemia leading to loss of immunity in pregnant women infected with falciparum malaria.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

Premji

Roopnarinesingh

Cohen

et al. 2016

Case Reports in Endocrinology

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Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated.

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Section: Discussionmentioning

confidence: 99%

Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

Premji

Roopnarinesingh

Cohen

et al. 2016

Case Reports in Endocrinology

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“…Many CM survivors suffer from long-term brain damage, as well as behavioural and mental health issues (common in children) [35]. Adults with hemiplegia, cerebral palsy, cortical blindness, deafness, cerebellar ataxia, and impaired cognition and learning are among the long-term consequences of CM [36].…”

Section: Clinical Features Of Cerebral Malariamentioning

confidence: 99%

Genetics of cerebral malaria: pathogenesis, biomarkers and emerging therapeutic interventions

et al. 2022

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Background Cerebral malaria (CM) is a preeminent cause of severe disease and premature deaths in Sub-Saharan Africa, where an estimated 90% of cases occur. The key features of CM are a deep, unarousable coma that persists for longer than 1 h in patients with peripheral Plasmodium falciparum and no other explanation for encephalopathy. Significant research efforts on CM in the last few decades have focused on unravelling the molecular underpinnings of the disease pathogenesis and the identification of potential targets for therapeutic or pharmacologic intervention. These efforts have been greatly aided by the generation and study of mouse models of CM, which have provided great insights into key events of CM pathogenesis, revealed an interesting interplay of host versus parasite factors that determine the progression of malaria to severe disease and exposed possible targets for therapeutic intervention in severe disease. Main Body This paper reviews our current understanding of the pathogenic and immunologic factors involved in CM. We present the current view of the roles of certain gene products e.g., the var gene, ABCA-1, ICAM-1, TNF-alpha, CD-36, PfEMP-1 and G6PD, in CM pathogenesis. We also present alterations in the blood–brain barrier as a consequence of disease proliferation as well as complicated host and parasite interactions, including the T-cell immune reaction, reduced deformation of erythrocytes and cytoadherence. We further looked at recent advances in cerebral malaria treatment interventions by emphasizing on biomarkers, new diagnostic tools and emerging therapeutic options. Conclusion Finally, we discuss how the current understanding of some of these pathogenic and immunologic factors could inform the development of novel therapeutic interventions to fight CM.

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Infiltrative and Inflammatory Disorders of the Hypothalamus and Pituitary

Fernandes

Varlamov

2022

Pituitary Disorders Throughout the Life Cycle

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Hypopituitarism: A rare sequel of cerebral malaria - Presenting as delayed awakening from general anesthesia

Cited by 4 publications

References 11 publications

Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

Genetics of cerebral malaria: pathogenesis, biomarkers and emerging therapeutic interventions

Infiltrative and Inflammatory Disorders of the Hypothalamus and Pituitary

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