ABSTRACT
AIMS AND OBJECTIVE: To study the clinical, biochemical and histopathological changes in the liver of patients of Plasmodium falciparum malaria with jaundice. MATERIAL AND METHOD: This study was conducted on 50 PBF confirmed cases of Plasmodium falciparum malaria with jaundice. Detailed history, clinical examination, biochemical parameters for liver function test and blood for hepatitis B and C was done in all patients. Liver biopsy was done for detailed histopathological examination in all the 20 patients having serum bilirubin between 3 to 10 mg%. All patients were treated by IV/oral quinine using standard regimen. RESULTS: Age of the patient was ranging from 15-45 years. All patients had jaundice, 70% had pallor, 56% had splenomegaly, 48% had hepatomegaly and 24% of cases had coma. Based on serum bilirubin level, the patients were categorized in group A (18 patients, serum bilirubin < 3 mg%), in group B (20 patients, serum bilirubin 3-10 mg%) and in group C (12 patients, serum bilirubin >10 mg%). Histopathological examination done in all the 20 patients of group B, showed evidence of swollen hepatocytes (100%), malarial pigment deposition (75%), inflammatory infiltrates (60%), congestion of hepatocyte (50%) alongwith centrizonal necrosis in 25% of cases. CONCLUSION: The evidence of predominant conjugated hyperbilirubinemia, increased levels of AST and ALT along with evidence of hepatocellular necrosis in histopathological examination are strong evidence of gross hepatocytic dysfunction in patients of Plasmodium falciparum malaria with jaundice. Therefore the term malarial hepatitis should not be taken as a misnomer.
Subject(s)
Acute Disease , Adolescent , Adult , Biopsy , Female , Hepatitis/etiology , Humans , Hyperbilirubinemia/etiology , Jaundice/complications , Malaria, Falciparum/complications , Male , Middle Aged , Prospective StudiesABSTRACT
Direct immunofluorescent studies of skin biopsies from 16 pemphigus vulgaris patients revealed immunoglobulin deposits in 12 (75%) cases with fluorescence at intercellular areas in epidermis. In 2 patients (12.5%) dermoepidermal junction also showed immunoglobulin deposits. IgG was the commonest type of immunoglobulin demonstrated in 12 out of 16 (75%) cases followed by IgM in 5 (31.25%) and IgA in 1 (6.25%) cases. Seven (43.75%) cases showed presence of IgG alone while IgM with IgG was found in 4 (25%) cases. One (6.25%) case showed deposition of IgG, IgM and IgA. The results indicated that demonstration of immunoglobulin in skin biopsies by direct immunofluorescent technique is quite a useful adjunct in diagnostic confirmation of pemphigus.
Subject(s)
Adult , Female , Fluorescent Antibody Technique , Humans , Immunoglobulin Isotypes/analysis , Male , Pemphigus/immunology , Skin/immunologySubject(s)
Aged , Blood Grouping and Crossmatching , Blood Transfusion/adverse effects , Diagnostic Errors , Female , HumansABSTRACT
Estimation of serum copper and ceruloplasmin was done in 25 non pregnant females, 25 healthy pregnant women followed from I to III trimester and 75 pregnant women with anaemia--25 in each trimester. Anaemia was further divided into mild, moderate and severe types (27, 32 & 16 cases respectively). Normal pregnancy was associated with progressive increase in serum copper and ceruloplasmin--values being highest in III trimester. All types of anaemias in pregnancy revealed statistically significant elevation of serum copper and ceruloplasmin when compared to corresponding gestational period in normal pregnancy.