title: A female patient with malarial nephropathy.
abstract: Malaria remains one of the world's major health problems, particularly in developing tropical countries. Imported malaria is reportedly increasing in Western countries. Acute renal failure (ARF) is the most common cause of death in severe malaria. We report the case of a 63-year-old female patient with a history of travel to a rural area in South Africa who was in coma and had a high fever on admission. Thirty percent of her erythrocytes were infected with Plasmodium falciparum. She had cerebral malaria, malarial nephropathy, anemia, hepatic dysfunction, and disseminated intravenous coagulation (DIC). Quinine and artesunate treatment decreased the number of parasites in the blood. To manage renal failure, hemodialysis was performed for 11 days. A relationship between ARF and hepatic dysfunction was suggested. This relationship is an indication of the clinical course of the disease. In this article, we discuss the mechanism underlying the development of malarial nephropathy and its management, particularly the usefulness of hemodialysis.
authors.affiliation: Department of Nephrology, Toride Kyodo Hospital, 2-1-1 Hongo, Toride, Ibaraki 302-0022, Japan. toride1kyodo1kid1kan@hotmail.com
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Kanda
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kida
authors.forename: Hitoe
authors.initials: H
authors.lastname: Suzuki
authors.forename: Minoru
authors.initials: M
authors.lastname: Ando
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Negishi
authors.forename: Sei
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000627:therapeutic use; D000077332:Artesunate; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D009393:Nephritis / Q000175:diagnosis / Q000209:etiology* / Q000469:parasitology* / Q000628:therapy; D010963:Plasmodium falciparum; D011803:Quinine / Q000627:therapeutic use; D006435:Renal Dialysis; D012717:Sesquiterpenes / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D000077332:Artesunate; D011803:Quinine