マラリア患者の黄だんについて

Abstract

The serum bilirubin of malaria patients was investigated in an effort to show that jaundice occuring in malaria patients differs from hepatocellular (hepatitis) and obstructive jaundice.1. The incidence of abnormally high serum total bilirubin (≥ 1.1 mg/dl) was more frequent in cases of falciparum than in vivax and ovale malaria patients put together (71% vs 49%, p <0.01). The maximum value of a falciparum malaria patient was 42.3 mg/dl.The following data were obtained concerning falciparum malaria : 2. All 14 patients showing ≥ 5.1 mg/dl of serum total bilirubin were moribund, and 7 of them died.3. A positive correlation was noted between the maximum parasite count and serum total bilirubin (p <0.01).4. The mean values of total, direct and indirect bilirubin and the ratio of direct / total (d/t) bilirubin were 9.4, 5.4, 3.9 mg/dl and 0.5, respectively. There were no significant differences in the mean and variance of direct and indirect bilirubin.5. A positive correlation was found between serum total bilirubin and d/t ratio (p < 0.02).6. The mean values of SGOT, SGPT, γ-GTP and LDH were 70, 132, 74 and 1, 110, respectively. The maximum value of LDH was 15, 140. The above data may prove to be helpful in differentiating jaundice in malaria patients from hepatocellular and obstructive jaundice.