Table of Contents  
COMMENTARY
Year : 2016  |  Volume : 9  |  Issue : 4  |  Page : 515  

Malarial pancreatitis


Tropical Medicine Unit, Hainan Medical University, Haikou, China; Department of Medicine, Faculty of Medicine, University of Nis, Nis, Serbia; Department of Biological Science, Joseph Ayo Babalola University, Ikeji-Arakeji, Nigeria; Department of Community Medicine, Dr. D. Y. Patil Medical University, India

Date of Web Publication12-Jul-2016

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok 10160, Thailand

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.186074

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How to cite this article:
Wiwanitkit V. Malarial pancreatitis. Med J DY Patil Univ 2016;9:515

How to cite this URL:
Wiwanitkit V. Malarial pancreatitis. Med J DY Patil Univ [serial online] 2016 [cited 2022 Oct 5];9:515. Available from: https://www.mjdrdypu.org/text.asp?2016/9/4/515/186074



Malaria is still public health concerns at present. It affects millions of people around the world, especially for those in poor developing countries. There are many kinds of malaria; at least nine types of classical and zoonotic malaria are proved to be a human pathogen. The classical clinical feature of malaria is an acute febrile illness. There are also possible complicated clinical problems due to malaria such as neurological, renal, and gastrointestinal problems. Focusing on the gastrointestinal problem, there are limited reports on this malarial complication. The present article on malarial pancreatitis is very interesting.[1] In fact, acute pancreatitis can be seen in several conditions. The alcohol drinking and stone are the two common etiologies. Focusing on infectious etiologies, there are some reports. Nevertheless, malaria is an extremely uncommon cause of acute pancreatitis. The first presentation can be the abdominal pain.[2] It is suggested that this condition has to be looked for in any patient with fever and abdominal pain and has the diagnosis of malaria.[2] The problem is more common in Falciparum malaria, but it can also be seen in other kinds of malaria such as Vivax malaria. The problem can be fatal if it is delayed diagnosed and managed.

Hemolysis due to malaria is believed to be an explanation on pathophysiology of acute malarial pancreatitis.[3] Druml et al. noted that “acute pancreatitis is a complication of massive hemolysis, occurring at a prevalence of above 20%”[3] and “it may progress from diffuse edema and inflammation to focal necrosis, rarely if ever to gross hemorrhage, and does not contribute to the high mortality of massive hemolysis.”[3] In some critical case, acute necrotizing hemorrhagic pancreatitis can also be seen.[4] Of interest, acute pancreatitis in malaria can be concomitantly seen with other complications. Multi-organ involvement is possible. The good example is the concurrent occurrence of acute malarial pancreatitis and respiratory distress syndrome.[5],[6] The occurrence of acute malarial pancreatitis, ascites and acute renal failure is another good example.[7] For conclusion, as noted by Thapa et al., “acute abdomen in Plasmodium falciparum infection may reveal pancreatitis which should be detected at the earliest.”[8] When the practitioner gets the patient malaria, looking for any complication is the rule. Asking about abdominal pain can be helpful and if there is a complaint, testing for liver function test and pancreatic enzyme is suggested.

 
  References Top

1.
Taye MK, Saloi DK, Choudhury B. Acute severe pancreatitis in falciparum malaria. Med J DY Patil Univ 2006;9:512-5.  Back to cited text no. 1
    
2.
Sarma PS, Kumar RS. Abdominal pain in a patient with falciparum malaria. Postgrad Med J 1998;74:425-7.  Back to cited text no. 2
    
3.
Druml W, Laggner AN, Lenz K, Grimm G, Schneeweiss B. Pancreatitis in acute hemolysis. Ann Hematol 1991;63:39-41.  Back to cited text no. 3
    
4.
Reoyo Pascual JF, Cartón-Hernández C, Valero-Cerrato X, León-Miranda R, García Plata-Polo E, Martínez-Castro RM, et al. Acute hemorrhagic necrotizing pancreatitis in falciparum malaria. Rev Esp Enferm Dig 2016;108:285-7.  Back to cited text no. 4
    
5.
Sharma A, Sharma V. Acute pancreatitis and ARDS complicating Plasmodium vivax malaria. J Vector Borne Dis 2013;50:323.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.
Gurman G, Schlaeffer F, Alkan M, Heilig I. Adult respiratory distress syndrome and pancreatitis as complications of falciparum malaria. Crit Care Med 1988;16:205-6.  Back to cited text no. 6
[PUBMED]    
7.
Lakhotia M, Pahadiya HR, Kumar H, Singh J, Sangappa JR, Choudhary PK. Acute pancreatitis, ascites, and acute renal failure in Plasmodium vivax malaria infection, a rare complication. Trop Parasitol 2015;5:120-2.  Back to cited text no. 7
[PUBMED]  Medknow Journal  
8.
Thapa R, Mallick D, Biswas B. Childhood Plasmodium falciparum malaria complicated by acute pancreatitis. Trop Doct 2010;40:184-5.  Back to cited text no. 8
    




 

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