LIVER PROFILE CHANGES AND COMPLICATIONS IN JAUNDICED PATIENTS WITH FALCIPARUM-MALARIA

To demonstrate the liver profile abnormalities in jaundiced falciparum malaria patients and to determine whether jaundice was associated wit h other complications in falciparum malaria, 390 patients with acute f alciparum malaria were studied. 124 patients were jaundiced and the ot hers were non-jaundiced. Hyperbilirubinemia (total serum bilirubin 3 t o 64 mg/dl) was found in jaundiced patients predominantly as unconjuga ted bilirubin. Asparatate amino-transferase and alanine minotransferas e were significantly higher in jaundiced patients (p < 0.01). There wa s a slight decrease of serum albumin in jaundiced malaria. The complic ations in jaundiced patients included cerebral malaria (n = 10), acute renal failure (n = 12), pulmonary edema (n = 3), shock (n= 3), and ot her severe malarial complications (n = 43). Jaundice was associated wi th cerebral malaria (p < 0.05), acute renal failure (p < 0.01), and hy perparasitemia (p < 0.01). After successful treatment, liver profile r eturned to normal within a few weeks. We found that jaundiced malaria patients had transient liver profile impairment which indicated predom inantly hemolysis rather than liver damage; complications were more fr equent in jaundiced patients.