Apheresis for severe malaria complicated by cerebral malaria, acute respiratory distress syndrome, acute renal failure, and disseminated intravascular coagulation

Lercari, G; Paganini, Giorgio; Malfanti, L.; Rolla, Davide; Machí, Anna Maria; Rizzo, F; Cannella, Giuseppe; Valbonesi, M

doi:10.1002/jca.2920070211

Cited by 11 publications

(3 citation statements)

References 11 publications

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“…Exchange transfusion is helpful in patients with heavy parasitemia, those with severe jaundice, and those with the SIR syndrome with an overall reduction of mortality by 20% (40). Apheresis has been reported to successfully support anuric patients with cerebral and pulmonary complications (41).…”

Section: Managementmentioning

confidence: 99%

Malarial Acute Renal Failure

Barsoum¹

2000

Journal of the American Society of Nephrology

154

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Malaria is an Italian word composed of "mala " and "aria," derived from malus (bad), and aeris (air). It was first used to describe a fever (miasma), which was wrongly attributed to exposure to poisonous air rising from marshes. Although the disease had been described in the Hippocratic Collection (460 to 377 BC) and its relation to mosquitoes suggested in the 5th century AD, by the Indian physician Susruta, it was only in 1880 that Charles Laveran, a French physician working in Algeria, discovered the true causative agent as being a sporozoan of the genus Plasmodium. More than a century later, we got to map the malaria genome, identifying a huge number of genes located on 14 chromosomes.Malaria is acquired through the sting of an infected Anopheles mosquito, which injects the sporozoites into the host's dermis. These are carried with the blood stream to the liver, where they mature in the hepatocytes (extra-erythrocytic cycle) to tissue schizonts that release their merozoites into the hepatic sinusoids. The latter invade the red cells, starting the erythrocytic cycle, which comprises ring forms, trophozoites, and, subsequently, schizonts that contain a new generation of merozoites. The parasitized cells are induced by plasmodial DNA to develop a microtubular system that conveys nutrients to the parasite. They eventually rupture and release the merozoites, which repeat the same cycle. A few merozoites are sexually differentiated into male and female gametocytes, which are essential for the completion of the sexual cycle in the vector. EpidemiologyMalaria is widely spread throughout the world and affects close to 400 million people, most of whom live in Africa, India, Southeast Asia, and Latin America. With the increasing immigration of natives from those regions to Europe and North America, "imported malaria" imposed itself on the list of differential diagnosis of many medical conditions in the West as recurrent fever, jaundice, hemolytic anemia, acute renal failure (ARF), systemic inflammatory response (SIR) syndrome, and posttransplantation pyrexia (1).An increasing number of Caucasians acquire the disease through traveling or living in endemic areas. This risk has been known for many centuries. Celebrities known to have contracted the disease while traveling to Africa or Asia include the Italian poet Guido Cavalcanti in 1300, the British explorer Sir Richard Burton in 1858, and the American president John F. Kennedy while serving in the Pacific during World War II. Malaria in nonimmune Caucasians is notoriously severe, with cerebral and renal complications often supervening with a fatal outcome.Infected mosquitoes can also travel with passengers or cargo and have been reported to transmit the disease to visitors of major European airports ("airport malaria"). They could even establish endemic foci in the West as reported from Belgium and the United States.

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Section: Managementmentioning

confidence: 99%

Malarial Acute Renal Failure

Barsoum¹

2000

Journal of the American Society of Nephrology

154

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“…In a similar vein, TPE for disseminated intravascular coagulation (DIC) secondary to an infectious etiology might successfully remove immune complexes, cytokines and fibrinogen degradation products, effectively replace clotting factors and improve circulation. Similar changes in inflammatory mediators have been postulated to explain why TPE alone or in conjunction with erythrocytapheresis has shown to be effective in cerebral malaria treatment (8). In the case of catastrophic antiphospholipid syndrome, TPE not only treats the DIC component of the disease, but also appears to effectively raise critically low platelet values to levels that allow institution of necessary anticoagulation.…”

mentioning

confidence: 64%

Therapeutic Plasma Exchange: An Underutilized Therapeutic Modality?

Pepkowitz

Ziman

2003

Ther Apher Dial

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Since its clinical availability approximately 25 years ago, therapeutic plasma exchange (TPE) has become recognized as appropriate primary therapy for many diverse medical conditions. In some aspects TPE has been constrained in its use according to schedules of efficacy. Expansion of TPE to other indications is likely once attention is focused on its ability to enable patients to avoid potentially toxic pharmacologic interventions if employed as a chronic therapy, and especially when it is accepted that adjunctive use, not only a curative role, is a valuable use of this therapeutic modality.

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“…Im Vordergrund der Therapie einer fulminanten Malaria tropica steht die unverzügliche parenterale Gabe von Chinin in Kombination mit dem schizontozid wirkenden Doxycyclin (6,7). Sind mehr als 20-30% der Erythrozyten mit Plasmodien infiziert, kann als weitere therapeutische Option eine Erythrozytenapherese durchgeführt werden (1,2,3,4). Dies führt zu einer Verminderung der Parasitämie, einer Reduktion inflammatorischer Zytokine und einer verbesserten Rheologie.…”

Section: Therapie Und Verlaufunclassified

Foudroyanter Verlauf einer Malaria tropica

Lamparter

Schoner²,

Moll³

et al. 2001

Dtsch med Wochenschr

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Severe Plasmodium falciparum infection in non-immunized patients is a medical emergency and requires immediate diagnosis and treatment. Malaria should always be considered in the differential diagnosis in persons who have travelled to endemic areas and presenting not only with temperatures, but also with non-specific clinical signs, like cardiac arrhythmias. Although never entirely effective, chemoprophylaxis is highly recommended.

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Apheresis for severe malaria complicated by cerebral malaria, acute respiratory distress syndrome, acute renal failure, and disseminated intravascular coagulation

Cited by 11 publications

References 11 publications

Malarial Acute Renal Failure

Malarial Acute Renal Failure

Therapeutic Plasma Exchange: An Underutilized Therapeutic Modality?

Foudroyanter Verlauf einer Malaria tropica

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