Abstract

Introduction: Severe falciparum malaria causes multiple organ dysfunction with different grades of severity that cause death. In

this study we investigate multiple endocrine gland dysfunction in severe falciparum malaria and its impact on outcome.

Material and Methods: 162 patients of severe and 43 patients of uncomplicated falciparum malaria (UM) were included. The

diagnosis of malaria was done either with the detection of asexual form of the parasite in the peripheral smear or by Rapid

diagnostic test. On admission blood was collected for estimation of serum cortisol, T3, T4, TSH, parathormone, Vit-D, Calcium,

phosphate, and Insulin in addition to hematological and biochemical investigations. Insulin resistance and beta cell function

were assessed by HOMA model.

Results: This study showed low cortisol (18.3±1.7μg/dl), low T3 (76.1±21.4 ng/ml), hypocalcemia (8.2±3.6 mg/dl),

hypophosphatemia (2.5±0.7mg/dl), low vitamin D (27.8±13.6 ng/ml) and low level of parathormone (5.4±2,8 pg/ml). There is

insulin resistance with beta cell dysfunction. These values are further lower among patients who died.

Conclusion: The present study showed that severe falciparum malaria causes multiple endocrine dysfunction that affect the

outcome adversely.