Correlation of Bilirubin with Liver Enzymes in Patients of Falciparum Malaria

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Correlation of Bilirubin with Liver Enzymes in Patients of Falciparum Malaria

Muhammad Waseem Kausar, Khalida Moeed, Naghmi Asif, Farwa Rizwi and Sajid Raza

Introduction: Falciparum malaria is responsible for 1-3 million deaths annually worldwide. Liver involvement is
common and may manifest as raised serum bilirubin, hepatomegaly and elevated liver enzymes. Unconjugated
hyperbilirubinemia is usually seen leading to increased mortality. Alanine aminotransferase (SGPT) is a marker of
liver damage. The present study was conducted on Plasmodium falciparum malarial patients to observe the correlation
between liver enzymes and bilirubin.
Objective: To observe the correlation coefficient of bilirubin with liver enzymes (SGPT, SGOT and Alkaline
Phosphatase) in patients of falciparum malaria
Design: A Descriptive study
Place and duration of study: Department of Biochemistry, Basic Medical Sciences Institute, JPMC, Karachi
from August 2005 to July 2006.
Material and method: Total 81 patients of different ages and both sexes suffering from acute malaria, were selected
by convenient sampling. Nine patients, infected by Hepatitis B and C infections were excluded from the
study. Among remaining 72 cases, 48 (70%) were suffering from infection by Plasmodium falciparum and 24
(30%) from infection by Plasmodium vivax infection. The Falciparum infected patients were equally divided into
two groups on the basis of duration of illness. Group I had duration of 1- 7days illness and Group II had duration of
8-20 days. Patients suffering from plasmodium vivax infection had illness of 1 – 20 days duration were placed in
Group III.
Results: In the group I, SGPT and Alkaline phosphatase showed a statistically significant positive correlation
(r=0.50 and r=0.054, respectively with bilirubin (P<0.05). In group II, the SGPT showed a statistically excellent positive correlation (r=0.88; P<0.01), while the SGOT and Alkaline phosphatase also showed a statistically significant positive correlation. In group III both aminotransferases and Alkaline phosphatase showed a statistically significant positive correlation r=0.82, 0.63 and 0.69 respectively. Conclusion: Positive correlation of liver enzymes and bilirubin shows that liver function tests should be performed along with early diagnosis of Plasmodium falciparum malarial infections in order to prevent complications and to reduce mortality. Key words: Malaria, liver enzymes, bilirubin, falciparum malaria

         

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