Calcium and phosphate metabolism in acute falciparum malaria.
1. Mineral homeostasis was investigated in 172 Thai adults with acute falciparum malaria at presentation (87 males, 85 females; mean age 30 years), and prospectively in a subgroup of 10 severely ill patients. 2. Mild, asymptomatic hypocalcaemia (corrected plasma calcium concentration 1.79-2.11 mmol/...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
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1991
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| _version_ | 1797075328820051968 |
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| author | Davis, T Pukrittayakamee, S Woodhead, J Holloway, P Chaivisuth, B White, N |
| author_facet | Davis, T Pukrittayakamee, S Woodhead, J Holloway, P Chaivisuth, B White, N |
| author_sort | Davis, T |
| collection | OXFORD |
| description | 1. Mineral homeostasis was investigated in 172 Thai adults with acute falciparum malaria at presentation (87 males, 85 females; mean age 30 years), and prospectively in a subgroup of 10 severely ill patients. 2. Mild, asymptomatic hypocalcaemia (corrected plasma calcium concentration 1.79-2.11 mmol/l) was found in 61 cross-sectional study patients (35.5%), with no difference between those with uncomplicated (2.16 +/- 0.10 mmol/l, mean +/- SD, n = 89) and severe (2.18 +/- 0.15 mmol/l, n = 83, P = 0.36) infections. Six prospectively studied patients were hypocalcaemic during treatment; simultaneous serum intact parathormone concentrations were inappropriately low (less than 5.0 pmol/l), but rose in three patients to high levels (11.8-16.4 pmol/l) on the fifth day. 3. Plasma phosphate concentration was decreased (less than 0.80 mmol/l) on admission in 74 patients (43.0%) and increased (greater than 1.45 mmol/l) in 15 (8.7%). Severe phosphate depletion (plasma phosphate concentration less than 0.30 mmol/l) occurred in 14 patients, of whom 11 had severe infections. Serum phosphate concentrations in the prospective study patients on admission (0.59 +/- 0.23 mmol/l) correlated significantly with the simultaneous renal threshold phosphate concentration (0.68 +/- 0.33 mmol/l; r = 0.607, P less than 0.025) and both parameters rose in parallel during treatment. 4. Plasma magnesium concentrations were normal (0.75-1.05 mmol/l) in 108 patients (62.8%); 45 cases (26.1%) had hypermagnesaemia and 19 (11.0%) had hypomagnesaemia. 5. These data suggest that mild hypocalcaemia is common in malaria regardless of disease severity; a depressed parathormone response may contribute. Despite malaria-associated haemolysis, hypophosphataemia is also common, but can be severe.(ABSTRACT TRUNCATED AT 250 WORDS) |
| first_indexed | 2024-03-06T23:48:56Z |
| format | Journal article |
| id | oxford-uuid:71eeb948-09e6-4ad5-a9a6-4d6e0826535f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:48:56Z |
| publishDate | 1991 |
| record_format | dspace |
| spelling | oxford-uuid:71eeb948-09e6-4ad5-a9a6-4d6e0826535f2022-03-26T19:46:49ZCalcium and phosphate metabolism in acute falciparum malaria.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:71eeb948-09e6-4ad5-a9a6-4d6e0826535fEnglishSymplectic Elements at Oxford1991Davis, TPukrittayakamee, SWoodhead, JHolloway, PChaivisuth, BWhite, N1. Mineral homeostasis was investigated in 172 Thai adults with acute falciparum malaria at presentation (87 males, 85 females; mean age 30 years), and prospectively in a subgroup of 10 severely ill patients. 2. Mild, asymptomatic hypocalcaemia (corrected plasma calcium concentration 1.79-2.11 mmol/l) was found in 61 cross-sectional study patients (35.5%), with no difference between those with uncomplicated (2.16 +/- 0.10 mmol/l, mean +/- SD, n = 89) and severe (2.18 +/- 0.15 mmol/l, n = 83, P = 0.36) infections. Six prospectively studied patients were hypocalcaemic during treatment; simultaneous serum intact parathormone concentrations were inappropriately low (less than 5.0 pmol/l), but rose in three patients to high levels (11.8-16.4 pmol/l) on the fifth day. 3. Plasma phosphate concentration was decreased (less than 0.80 mmol/l) on admission in 74 patients (43.0%) and increased (greater than 1.45 mmol/l) in 15 (8.7%). Severe phosphate depletion (plasma phosphate concentration less than 0.30 mmol/l) occurred in 14 patients, of whom 11 had severe infections. Serum phosphate concentrations in the prospective study patients on admission (0.59 +/- 0.23 mmol/l) correlated significantly with the simultaneous renal threshold phosphate concentration (0.68 +/- 0.33 mmol/l; r = 0.607, P less than 0.025) and both parameters rose in parallel during treatment. 4. Plasma magnesium concentrations were normal (0.75-1.05 mmol/l) in 108 patients (62.8%); 45 cases (26.1%) had hypermagnesaemia and 19 (11.0%) had hypomagnesaemia. 5. These data suggest that mild hypocalcaemia is common in malaria regardless of disease severity; a depressed parathormone response may contribute. Despite malaria-associated haemolysis, hypophosphataemia is also common, but can be severe.(ABSTRACT TRUNCATED AT 250 WORDS) |
| spellingShingle | Davis, T Pukrittayakamee, S Woodhead, J Holloway, P Chaivisuth, B White, N Calcium and phosphate metabolism in acute falciparum malaria. |
| title | Calcium and phosphate metabolism in acute falciparum malaria. |
| title_full | Calcium and phosphate metabolism in acute falciparum malaria. |
| title_fullStr | Calcium and phosphate metabolism in acute falciparum malaria. |
| title_full_unstemmed | Calcium and phosphate metabolism in acute falciparum malaria. |
| title_short | Calcium and phosphate metabolism in acute falciparum malaria. |
| title_sort | calcium and phosphate metabolism in acute falciparum malaria |
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