Levels of Serum Thmor Necrosis Factor Alpha in Relation to Clinical Involvement and Treatment Among Thai Adults with Plasmodium falciparum Malariat
SUPORN CHUNCHARUNEE,M.D.*, APICHAI LEELASIRI, M.D.**, WICHAI PRAYOONWIWAT, M.D.**, PIANVIT POLVICHA, M.D.**, SAENGSUREE JOOTAR, M.D.*, NAPAPORN ARCHARARIT, M.Sc.***, WICHIAN MONGKONSRITRAGOON, M.D.**, T ANOMSRI SRICHAIKUL, M.D.**
Affiliation : * Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, ** Pramongkutklao Hospital, Bangkok 10400, *** Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. t This study was supported by the Research Grant from Faculty of Medicine, Ramathibodi Hospital, Mahidol University.
Abstract Concentrations of tumor necrosis factor alpha (TNF-a) in serum were measured in 17 Thai men infected with Plasmodium falciparum malarial infections to determine whether they were affected by severity of infections or exchange transfusions. Twelve patients were considered having complicated malarial infections, eight of whom had cerebral malaria. Five patients had uncomplicated malarial infections. The results showed that malarial infection markedly raised TNF-a level above normal values (mean± SEM 406 ± 38 vs 15 ± 5, p = 0.004). In complicated malaria, cerebral involvement appeared to significantly increase concentration of TNF-a when compared to values in uncomplicated malaria (mean ± SEM 496 ± 64 vs 339 ± 12, p = 0.0 I). Degree of parasitemia, intravenous quinine (day 0 value vs day 7 value) and exchange transfusion did not significantly affect TNF-a levels. Conclusion : Serum level of TNF-a is increased in Plasmodium falciparum malarial in- fections and may be a useful index to predict severity of malarial infection, cerebral malaria in particular.
Keywords :
