Liver function abnormalities in falciparum malaria

Abstract

Background: Malaria still continues to be a major killer of mankind especially in developing countries. Almost all deaths and severe disease are due to Plasmodium falciparum. It is observed that the patients of falciparum malaria with liver function abnormalities are more vulnerable to the development of complications like cerebral malaria, anemia, renal failure, acute respiratory distress syndrome, etc. Methods: 50 cases of Plasmodium falciparum malaria diagnosed by peripheral smear examination or by immunochromatographic test-falci check, pan malaria or by rapid optimal test were included in the study. All these patients were subjected to blood investigations like hemoglobin level, total leukocyte count, differential count, renal function tests, liver function tests and random blood sugar. Results: Serum bilirubin level was raised in 66% of cases with 28% of cases showing levels above 3.0g/dL. Patients with clinical jaundice showed mean 2-3 fold raise in AST levels along with ALT levels. 64% of cases had normal ALK levels. Serum proteins found to be normal in 92% of cases. Conclusions: Deranged liver functions are commonly seen as a complication of severe malarial infection. Presence of raised hepatic enzymes with near normal coagulation parameters, in presence of documented malarial infection should suggest presence of malarial hepatopathy.

Investigating the comparative effects of six artemisinin-based combination therapies on Plasmodium-induced hepatorenal toxicity

“…The marginal rise in the PNT ALP level indicates that the ACTs have greater effect on cholestasis damage than that induced by the Plasmodium parasite. This finding, while agreeing with views that increase in liver enzymes, is directly proportional to increase in malaria parasite density, indicates that ALP does not fit into this general assumption 5051. ALP in mice liver is localized mainly in the canalicular membrane of the hepatocytes, whereas in the human liver, it is found in the endothelial cells around the portal and central veins as well as in the sinusoids around the central veins and sometimes around the bile canaliculi 49.…”

Antimalarial Efficacy and Safety of Senna occidentalis (L.) Link Root Extract in Plasmodium berghei‐Infected BALB/c Mice

“…In the current study, total protein, bilirubin, ALT, and ALP were significantly elevated in P. berghei -infected mice, an indication of decreased liver function. This observation concurs with previous reports regarding P. falciparum infection in human [ 65 , 68 ]. The AST/ALT ratio was at least 1.4-fold higher in the untreated P. berghei -infected mice compared with the uninfected animals.…”

Evaluation of liver function test in malaria positive cases in tertiary care hospital of Bareilly

“…In contrast Kotresh et al found deranged ALP in 36% in P. falciparum cases. 33,35 In contrast Okwubuo et al found 00.00% deranged ALP. 24…”

“…Out of total 502 cases of malaria, 63.75% were having above normal limit serum bilirubin and maximum abnormal serum bilirubin (83.33%) was found in P. falciparum followed by (73.97%) in mixed malarial infection cases and least (61.70%) in P. vivax cases Kotresh et al found deranged serum bilirubin in 66% cases. 33 Dhariyal et al found deranged serum bilirubin (56.25%). 34 Sridhar et al found deranged serum bilirubin in P. falciparum (36.36%) and in P. vivax (49.43%).…”

“…21,24,34 In contrast Abro et al found deranged SGPT (67.6%) and Kotresh et al found 78% cases have deranged SGPT in P. falciparum. 33,36 Divyaansh et al found deranged SGPT in P. vivax (53.93%) and in P. falciparum (81.81%). 31,35 In this study, deranged SGOT in 70.52% malarial cases were found while 100% in P. falciparum followed by 84.93% in mixed infection and least 67.61% in P. vivax cases.…”