A Case of Plasmodium vivax Malaria Complicated with Acute Renal Failure, Jaundice and Thrombocytopenia

Korean Journal of Nephrology 2010;29(6):792-795.

Hyun Jung Kim, M.D.1, Seo Hyun Lee, M.D.1, Tai Yeon Koo, M.D.1, Kyung Min Kim, M.D.1, Sung Soo Jang, M.D.2 and Sang Koo Lee, M.D.1

Division of Nephrology1 and Department of Laboratory Medicine²
Asan Medical Center, University of Ulsan, Seoul, Korea

증례 : 급성 신부전, 황달 및 혈소판 감소증이 병발된 삼일열 말라리아 1예

김현정1, 이서현1, 구태연1, 김경민1, 장성수2, 이상구1

서울아산병원 신장내과1, 진단검사의학과2

Abstract

Malaria is caused by four species of the genus Plasmodium. Plasmodium vivax malaria is the most common malarial infection in Korea and usually has benign clinical course. However, serious complications such as severe anemia, pulmonary edema, acute renal failure are reported in Plasmodium vivax malaria. We report a case of Plasmodium vivax malaria complicated with acute renal failure, jaundice and thrombocytopenia. A 56-year-old male was transferred to our hospital with acute renal failure, jaundice and thrombocytopenia. 10 days before admission, he had intermittent fever, chill, myalgia, and was treated with some medications under the impression of URI. Laboratory findings showed that hemoglobin was 11.5 g/dL, platelet 44,000/mm3, blood urea nitrogen 73 mg/dL, creatinine 4.0 mg/dL, total bilirubin 5.2 mg/dL, direct bilirubin 4.0 mg/dL. Serologic tests for leptospirosis, rickettsia, EB virus and CMV were negative. Ring form trophozoites were found in red blood cells, suggesting Plasmodium vivax malaria. Following anti-malarial therapy, acute renal failure, jaundice and thrombocytopenia were recovered to normal. From this case, malarial infection should be included as a differential diagnosis in a febrile patient with acute renal failure, jaundice and thrombocytopenia.

Key Words: Plasmodium vivax, Jaundice, Thrombocytopenia, Acute renal failure