title: Serum Ornithine Carbamoyl Transferase as a Surrogate Marker in Malaria.
abstract: Ornithine carbamoyl transferase (OCT) activity and other liver function tests were studied in a total of 50 patients of clinical malaria and 15 controls. They were grouped as group I (positive for malarial parasite on peripheral blood smear, n=18), group II (negative for malarial parasite on peripheral blood smear (PBS) but responded to antimalarials, n=17) and group III (peripheral blood smear negative and did not respond to antimalarial therapy, n=15). The mean OCT levels were significantly raised in group I (6.79 ± 1.84 IU/L, p value = 0.006) and group II (5.0 ± 1.15 IU/L, p value = 0.014) as compared to controls (2.5 ± 1.13 IU/L) and returned to normal after treatment In contrast, group III had normal levels except in a case of kala azar and septicemia where OCT levels were high and increased further on treatment. Taking PBS positivity as a gold standard of diagnostic criteria, OCT had a sensitivity of 83% and specificity of 86% with a high positive predictive value of 88% as compared to ALT which had a lower sensitivity of 55% and specificity of 80%. The clinical response rate in PBS negative cases of fever having high OCT level was 83% as compared to 35% in cases with normal OCT level, making OCT a good surrogate marker of malaria. OCT levels could also be of prognostic significance as 2 cases of cerebral malaria had high OCT levels of 11.1 UAL and 10.7 IU/L, respectively.
authors.affiliation: Graded Specialist (Pathology), 5 Air Force Hospital, C/o 99 APO.
authors.forename: S
authors.initials: S
authors.lastname: Sampath
authors.affiliation: Scientist F, Department of Biochemistry, Armed Forces Medical College, Pune - 411 040.
authors.forename: B L
authors.initials: BL
authors.lastname: Somani
authors.affiliation: Senior Advisor (Pathology), Command Hospital (Northern Command), C/o 56 APO.
authors.forename: Y V
authors.initials: YV
authors.lastname: Sharma
authors.affiliation: Head, Department of Biochemistry, Armed Forces Medical College, Pune - 411 040.
authors.forename: M M
authors.initials: MM
authors.lastname: Arora
authors.affiliation: Scientist D, Department of Biochemistry, Armed Forces Medical College, Pune - 411 040.
authors.forename: V N
authors.initials: VN
authors.lastname: Arabade
keywords: Malaria; Ornithine carbamoyl transferase