1921
Volume 77, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Metabolic acidosis is a common complication of severe malaria caused by . The factors contributing to the acidosis were assessed in 62 children with severe malaria (cases) and in 29 control children who had recently recovered from mild or moderate malaria. The acidosis was largely caused by the accumulation of both lactic and 3-hydroxybutyric acids. The determinants of oxygen release to the tissues were also examined; although there was no difference between cases and controls in respect of 2,3-bisphosphoglycerate and mean corpuscular hemoglobin concentration, there was a marked increase in in the cases, caused by pyrexia, low pH, and base deficit. There was substantial relative or actual hypoglycemia in many cases. The relationship of these observations to therapeutic strategy is discussed.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2007.77.256
2007-08-01
2017-09-22
Loading full text...

Full text loading...

/deliver/fulltext/14761645/77/2/0770256.html?itemId=/content/journals/10.4269/ajtmh.2007.77.256&mimeType=html&fmt=ahah

References

  1. Krishna S, Waller DW, ter Kuile F, Kwiatowski D, Crawley CFC, Craddock CF, Nosten F, Chapman D, Brewster D, Holloway PA, 1994. Lactic acidosis and hypoglycaemia in children with severe malaria: pathophysiological and prognostic significance. Trans R Soc Trop Med Hyg 88 : 67–73.
  2. English M, Sauerwein R, Waruiru C, Mosobo M, Obeiro J, Lowe B, Marsh K, 1997. Acidosis in severe childhood malaria. Q J Med 90 : 263–270.
  3. English M, Muambi B, Mithwani S, Marsh K, 1977. Lactic acidosis and oxygen debt in African children with severe anaemia. Q J Med 90 : 563–569.
  4. Warrell DA, White NJ, Veall N, Looaresuwan S, Krishna S, Pongpaew P, 1988. Cerebral anaerobic glycolysis and reduced cerebral oxygen transport in human cerebral malaria. Lancet 1 : 5384–5388.
  5. Pukrittayamakamee S, White NJ, Davis TME, Looaresuwan S, Supanarnond W, Desakorn V, Chaivisuth B, Williamson DH, 1992. Hepatic blood flow and metabolism in severe falciparum malaria: clearance of intravenously administered galactose. Clin Sci 82 : 63–70.
  6. Bellingham AJ, Detter JC, Lenfant C, 1971. Regulatory mechanisms of hemoglobin oxygen affinity in acidosis and alkalosis. J Clin Invest 50 : 700–706.
  7. Alberti KGMM, Darley JH, Emerson PM, Hockaday TDR, 1972. 2,3-bisphosphoglycerate and tissue oxygenation in uncontrolled diabetes mellitus. Lancet 3 : 391–395.
  8. Beech JS, Williams SCR, Iles RA, Cohen RD, Nolan KM, Evans SJW, Going TCD, 1995. Hemodynamic and metabolic effects in diabetic ketoacidosis in rats of treatment with sodium bicarbonate or a mixture of sodium bicarbonate and sodium carbonate. Diabetologia 38 : 889–898.
  9. Krishna S, Showbridge EA, White NJ, Weatherall DJ, Radda GK, 1983. Plasmodium yoelii: blood oxygen and brain function in the infected mouse. Exp Parasitol 56 : 391–396.
  10. Cohen RD, 1994. Lactic acidosis: new perspectives on origins and treatment. Diabetes Reviews 2 : 86–97.
  11. Cohen RD, 1995. New evidence in the bicarbonate controversy. Appl Cardiopulm Pathophysiol 5 : 135–138.
  12. Marsh K, Forster D, Wairuru C, Mwangi I, Winstanley M, Marsh V, Newton C, Winstanley P, Warn P, Peshu N, Pasvol G, Snow R, 1995. Indicators of life-threatening malaria in African children: clinical spectrum and simplified prognostic criteria. N Engl J Med 332 : 1399–1404.
  13. Iles RA, Hind AJ, Chalmers RA, 1985. Use of proton magnetic resonance spectroscopy for the detection and study of organic acidurias. Clin Chem 31 : 1795–1801.
  14. Bartels PD, Lund-Jacobsen H, 1986. Blood lactate and ketone body concentrations in salicylate intoxication. Hum Toxicol 5 : 363–366.
  15. Trivedi B, Danforth WH, 1966. Effect of pH on kinetics of frog muscle phosphofructokinase. J Biol Chem 241 : 4110–4112.
  16. Ui M, 1966. A role of phosphofructokinase in pH-dependant regulation of glycolysis. Biochim Biophys Act 124 : 310–322.
  17. Gevers W, Dowdle E, 1963. The effect of pH on glycolysis. Clin Sci 25 : 343–349.
  18. Scrutton MC, Utter MF, 1967. Pyruvate carboxylase IX. Some properties of the activation by certain acyl derivatives of coenzyme A. J Biol Chem 242 : 1723–1735.
  19. Iles RA, Cohen RD, Rist AH, Baron PG, 1977. The mechanism of inhibition by acidosis of gluconeogenesis in the isolated perfused rat liver. Biochem J 164 : 185–191.
  20. Kashiwagura T, Deutsch CJ, Taylor T, Erecinska M, Wilson DF, 1984. Dependence of gluconeogenesis, urea synthesis and energy metabolism of hepatocytes on intracellular pH. J Biol Chem 259 : 237–243.
  21. Pfaller MA, Parquette AR, Krogstad DJ, Nguyen-Dinh P, 1982. Plasmodium falciparum stage-specific lactate production in synchronized cultures. Exp Parasitol 54 : 391–396.
  22. Torrance J, Jacobs P, Lenfant C, Finch CA, 1970. Intraerythrocytic adaptation to anemia. N Engl J Med 283 : 165–169.
  23. Molyneux ME, Taylor TE, Wirima JJ, Borgstein A, 1989. Clinical features and prognostic indicators in pediatric cerebral malaria: a study of 131 comatose Malawian children. Q J Med 71 : 441–459.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2007.77.256
Loading
/content/journals/10.4269/ajtmh.2007.77.256
Loading

Data & Media loading...

  • Received : 26 Feb 2007
  • Accepted : 27 Apr 2007

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error