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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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