Background
Methods
Liver tissue specimens from malaria patients and controls
Liver tissue preparation
Histology of liver in severe P. falciparum malaria
Histopathologic changes | Histopathologic grading | |||
---|---|---|---|---|
0 | 1 | 2 | 3 | |
Fatty change | No fatty change | < 10% | 10-50% | > 50% |
Kupffer cells/HPF | < 20/HPF | 20-35/HPF | 36-50/HPF | > 50/HPF |
Portal tract inflammation | < 5% of portal tract area | 5-15% of portal tract area | 16-30% of portal tract area | > 30% of portal tract area |
Bile duct proliferation | No proliferation | Mild proliferation | Moderate proliferation | Severe proliferation |
Sinusoid congestion | No congestion | Mild congestion | Moderate congestion | Severe congestion |
Haemozoin deposition | No deposition | Mild deposition | Moderate deposition | Severe deposition |
Immunohistochemical staining of cleaved caspase-3 and NF-κB p65
Cleaved caspase-3 and NF-κB p65 analysis
Measurement of Kupffer cell length
Statistical analysis
Results
Malaria patients
Non-hyperbilirubinaemia (TB < 51.3 μmol/L) (n = 10) | Hyperbilirubinaemia (TB ≥ 51.3 μmol/L) (n = 12) | |
---|---|---|
Age (years) (p = 0.974) | 25.8 ± 3.95 | 26.17 ± 4.28 |
Sex (M:F) | 6:4 | 10:2 |
Days of fever (p = 0.095) | 4.1 ± 0.82 | 5.83 ± 0.77 |
Parasitaemia (/μl) (p = 0.619) | 303,186.67 ± 151,070.30 | 391,501.40 ± 183,362.30 |
Albumin (g/L) (p = 0.006) | 33.2 ± 0.17 | 25.3 ± 0.13 |
AST (U/L) (p = 0.006) | 72.00 ± 21.41 | 266.33 ± 64.93 |
ALT (U/L) (p = 0.049) | 49.17 ± 8.23 | 126.79 ± 29.22 |
Alkaline phosphatase (U/L) (p = 0.049) | 8.42 ± 2.62 | 20.07 ± 4.33 |
Total bilirubin (μmol/L) (p = 0.001) | 30.61 ± 0.31 | 441.60 ± 5.39 |
Direct bilirubin (μmol/L) (p = 0.001) | 8.55 ± 0.15 | 217.17 ± 2.73 |
Histopathology of liver in severe P. falciparum malaria
Histopathologic changes | Histopathologic grading | ||
---|---|---|---|
Normal liver | Non-hyperbilirubinaemia (TB < 51.3 μmol/L) | Hyperbilirubinaemia (TB ≥ 51.3 μmol/L) | |
Fatty change | 0 | 0 | 0 |
Kupffer cells hyperplasia | 0 | 1 | 3 |
Portal tract inflammation | 1 | 2 | 3 |
Bile duct proliferation | 0 | 0 | 0 |
Sinusoid congestion | 0 | 2 | 3 |
Haemozoin deposition | 0 | 3 | 3 |
Total histological score | 1/18 | 8/18 | 12/18 |
Histopathological changes | Normal liver (n = 10) | Non-hyperbilirubinaemia (TB < 51.3 μmol/L) (n = 10) | Hyperbilirubinaemia (TB ≥ 51.3 μmol/L) (n = 12) |
---|---|---|---|
Fatty changes (%/HPF) | 0.59 ± 0.25 | 1.71 ± 0.46 | 1.97 ± 0.67 |
Hyperplastic Kupffer cells (count/HPF) | 9.65 ± 0.67 | 32.05 ± 3.34a | 52.21 ± 2.32a,b |
Portal tract inflammation (%) | 5.49 ± 1.20 | 17.1 ± 1.62a | 32.79 ± 2.48a,b |