The role of previously unmeasured organic acids in the pathogenesis of severe malaria

Critical Care : the Official Journal of the Critical Care Forum
M Trent HerdmanArjen M Dondorp

Abstract

Severe falciparum malaria is commonly complicated by metabolic acidosis. Together with lactic acid (LA), other previously unmeasured acids have been implicated in the pathogenesis of falciparum malaria. In this prospective study, we characterised organic acids in adults with severe falciparum malaria in India and Bangladesh. Liquid chromatography-mass spectrometry was used to measure organic acids in plasma and urine. Patients were followed until recovery or death. Patients with severe malaria (n=138), uncomplicated malaria (n=102), sepsis (n=32) and febrile encephalopathy (n=35) were included. Strong ion gap (mean ± SD) was elevated in severe malaria (8.2 mEq/L ± 4.5) and severe sepsis (8.6 mEq/L ± 7.7) compared with uncomplicated malaria (6.0 mEq/L ± 5.1) and encephalopathy (6.6 mEq/L ± 4.7). Compared with uncomplicated malaria, severe malaria was characterised by elevated plasma LA, hydroxyphenyllactic acid (HPLA), α-hydroxybutyric acid and β-hydroxybutyric acid (all P<0.05). In urine, concentrations of methylmalonic, ethylmalonic and α-ketoglutaric acids were also elevated. Multivariate logistic regression showed that plasma HPLA was a strong independent predictor of death (odds ratio [OR] 3.5, 95 % confidence interval [CI]...Continue Reading

References

Oct 12, 1973·Clinica Chimica Acta; International Journal of Clinical Chemistry·J E PettersenL Eldjarn
Jun 3, 1982·The New England Journal of Medicine·L StolbergS Finegold
Jun 1, 1995·Journal of Applied Physiology·J A KellumM R Pinsky
Jul 11, 1996·The New England Journal of Medicine·T H TranN J White
Jan 1, 1996·Kidney International·M L Halperin, K S Kamel
Jan 11, 2000·QJM : Monthly Journal of the Association of Physicians·C O EnwonwuR A Rabiu
Mar 1, 1964·Clinica Chimica Acta; International Journal of Clinical Chemistry·J M HICKSI D WOOTTON
Aug 3, 2004·Critical Care Medicine·Arjen M DondorpNicholas P J Day
Nov 5, 2004·PLoS Medicine·Timothy PlancheSanjeev Krishna
Aug 18, 2005·PLoS Medicine·Arjen M DondorpNicholas P J Day
Nov 1, 2005·Transactions of the Royal Society of Tropical Medicine and Hygiene·P SasiG Kokwaro
Nov 10, 2005·Critical Care : the Official Journal of the Critical Care Forum·Lui G ForniPhilip J Hilton
Dec 20, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Howard E CoreyJuan Rodríguez-Soriano
Dec 27, 2005·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A AssadianW Hübl
Jun 17, 2006·The Journal of Infectious Diseases·Karl B SeydelTerrie E Taylor
Jan 4, 2008·The Journal of Infectious Diseases·A M DondorpN P J Day
Jun 7, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Arjen M DondorpNicholas J White
Oct 30, 2008·Proceedings of the National Academy of Sciences of the United States of America·Tsin W YeoNicholas M Anstey
Apr 7, 2009·Transactions of the Royal Society of Tropical Medicine and Hygiene·Richard J MaudeArjen M Dondorp
Jan 29, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Josh HansonArjen M Dondorp
Sep 21, 2010·Molecular and Biochemical Parasitology·Kellen L Olszewski, Manuel Llinás
Oct 16, 2010·PloS One·Fabrice BruneelUNKNOWN Severe Imported Malaria in Adults (SIMA) Study Group
Jun 14, 2012·The Journal of Infectious Diseases·Josh HansonArjen M Dondorp
Oct 16, 2012·Journal of Biomedical Science·Natalia BeloborodovaNadezhda Fedotcheva
Nov 10, 2013·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·Natthida SriboonvorakulNiklas Lindegardh

❮ Previous
Next ❯

Citations

Dec 20, 2018·The Journal of Infectious Diseases·Stije J LeopoldArjen M Dondorp
Mar 24, 2018·Malaria Journal·Natthida SriboonvorakulArjen M Dondorp
Nov 4, 2015·Critical Care : the Official Journal of the Critical Care Forum·M Trent HerdmanArjen M Dondorp
Jul 28, 2020·Malaria Journal·Rosauro VaroKevin C Kain
Jan 8, 2021·PLoS Pathogens·Hendrik PossemiersPhilippe E Van den Steen

❮ Previous
Next ❯

Methods Mentioned

BETA
enzyme-linked immunosorbent assay

Software Mentioned

STATA
IC
iSTAT
Prism

Related Concepts

Related Feeds

Antimalarial Agents (ASM)

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Antimalarial Agents

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.