P. vivax Malaria presenting as Thrombotic Microangiopathy.
J Assoc Physicians India
; 65(9): 28-31, 2017 Sep.
Article
em En
| MEDLINE
| ID: mdl-29313573
ABSTRACT
INTRODUCTION:
Acute kidney injury (AKI) is reported to occur in patients with falciparum malaria but not uncommon with vivax malaria. AKI, anemia, thrombocytopenia and jaundice is a recurrent finding in severe malaria and can mimic as thrombotic microangiopathy (TMA). Relationship of malaria with TMA is unclear till date however evidences suggest their association. METHODS &MATERIAL:
We reviewed our electronic database to evaluate relationship of malaria with TMA, of cases of malaria, jaundice and AKI.RESULTS:
4 patients found to have P. vivax malaria and histopathologically confirmed TMA. All had fever, oliguria, jaundice at presentation. The time between onset of symptoms and admission ranged from 7 to 14 days. All had parasitemia at presentation so were treated with Artesuanate. Hemodialysis and Plasmapheresis was done in all patients. On follow-up all patients recovered and asymptomatic urinary abnormality persisting in one patient.CONCLUSION:
High index of suspicion should be kept for TMA in a patient who has nonrecovering AKI with persistent anemia and thrombocytopenia even after clinical and laboratory evidences of recovery from malaria, as response to plasmapheresis seems excellent in this subset of malarial AKI. There could be a pathogenetic link between P.vivax and TMA though yet to be confirmed in larger studies.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Malária Vivax
/
Microangiopatias Trombóticas
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Assoc Physicians India
Ano de publicação:
2017
Tipo de documento:
Article