Glomerular thrombotic microangiopathy caused by Plasmodium vivax infection

Abstract

Acute renal failure, although less commonly seen in P. vivax than P. falciparum infection, may be associated with significant morbidity and even mortality. The exact pathogenesis of vivax related renal failure is unknown as renal biopsies are done infrequently. We report a 10 year old boy with renal failure and severe thrombocytopenia due to vivax infection wherein the renal histopathological examination revealed thrombotic microangiopathy. We suggest this as one of the important underlying mechanisms of vivax-induced renal failure.

Keywords

• vivax malaria
• renal failure
• thrombocytopenia
• thrombotic microangiopathy

Kaynakça

1. Kochar DK, Das A, Kochar SK, et al. Severe Plasmodium vivax malaria: a report on serial cases from Bikaner in northwestern India. Am J Trop Med Hyg 2009; 80:194-8.
2. Kanodia KV, Shah PR, Vanikar AV, et al. Malaria induced acute renal failure: a single center experience. Saudi J Kidney Dis Transpl 2010;21:1088-91.
3. Srivastava S, Ahmad S, Shirazi N, et al. Retrospective analysis of vivax malaria patients presenting to tertiary referral centre of Uttarakhand. Acta Trop 2011;117:82-5.
4. Jakobsen PH, Morris-Jones S, Ronn A, et al. Increased plasma concentrations of sICAM-1, sVCAM-1 and sELAM-1 in patients with Plasmodium falciparum or P. vivax malaria and association with disease severity. Immunology 1994;83:665-9.
5. Saharan S, Kohli U, Lodha R, Sharma A, Bagga A. Thrombotic microangiopathy associated with Plasmodium vivax malaria. Pediatr Nephrol 2009;24:623-4.
6. Sharma J, Bharadawa K, Shah K, Dave S. Plasmodium vivax malaria presenting as hemolytic--uremic syndrome. Indian Pediatr 1993;30:369-71.
7. Das BS. Renal failure in malaria. J Vector Borne Dis 2008;45:83-97.
8. Devidayal, Jabbar Z, Kumar S, Singh M. Acute renal failure and severe thrombocytopenia in a young boy with vivax malaria. Journal of Pediatric Infectious Diseases 2008;3:145-7.

9. Caprioli J, Remuzzi G, Noris M. Thrombotic microangiopathies: from animal models to human disease and cure. Contrib Nephrol 2011;169:337-50. 10
10. microangiopathies:thrombotic thrombocytopenic purpura hemolytic uremic syndrome.J Bras Nefrol 2010;32:303-15. 11- Keir L, Coward RJ. Advances in our understanding of the
11. microangiopathy. Pediatr Nephrol 2011;26:523-33. of glomerular
12. thrombotic 12- Waters AM, Licht C. aHUS caused by complement dysregulation: new therapies on the horizon. Pediatr Nephrol 2011;26:41-57.
13. Douglas NM, Anstey NM, Angus BJ, Nosten F, Price RN. Artemisinin combination therapy for vivax malaria. Lancet Infect Dis 2010;10:405-16.
14. Bharti PK, Silawat N, Singh PP, et al. The usefulness of a new rapid diagnostic test, the First Response Malaria Combo (pLDH/HRP2) card test, for malaria diagnosis in the forested belt of central India. Malar J 2008;7:126.