Malarial hepatopathy

Abstract

Background: Malaria has been a major health burden in numerous tropical countries, resulting in considerable morbidity among various age groups. Liver dysfunction in malaria is multifactorial and its incidence varies in different regions. There is a paucity of data with regard to malarial hepatopathy and its outcome at the global level. Aim: The study was conducted to assess the clinical pattern, spectrum of biochemical parameters and complications of hepatopathy related to malaria. Methods: This retrospective study was carried out at two tertiary care hospitals (PSG hospitals and Fr muller hospital). 200 patients diagnosed to have malaria by Peripheral smear and Fluorescent staining test were included. Data were collected and analyzed. Results: About three fourths were males. The age of the patients ranged between 15-86 years (mean 37). Approximately 70 % of patients had Plasmodium vivax malaria, 11 % had Plasmodium falciparum and remaining 19 % mixed malaria. Serum bilirubin levels ranged from 0.3 to 32 mg% (mean of 3.04). About 30% of patients had elevated liver enzymes (>3 times upper limit) along with jaundice, only 2 had liver enzymes more than 10 times the normal level., 4 patients had multiorgan failure. Conclusion: Hepatic dysfunction ranges from a mild elevation of liver enzymes to the range of acute hepatitis.The presence of hepatitis in patients with malaria indicates a more severe illness with a higher incidence of complications, further studies are required to elucidate the factors associated with malarial hepatopathy and to prevent the complications and mortality.