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Cerebral malaria: insight into pathogenesis, complications and molecular biomarkers

Authors Yusuf FH, Hafiz MY, Shoaib M, Ahmed SA

Received 22 October 2016

Accepted for publication 6 January 2017

Published 2 February 2017 Volume 2017:10 Pages 57—59

DOI https://doi.org/10.2147/IDR.S125436

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Farah Hafiz Yusuf,1 Muhammad Yusuf Hafiz,1 Maria Shoaib,1 Syed Ahsanuddin Ahmed2

1Department of Medicine, Dow Medical College, Dow University of Health Sciences, 2Department of Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan

Abstract: Cerebral malaria is a medical emergency. All patients with Plasmodium falciparum malaria with neurologic manifestations of any degree should be urgently treated as cases of cerebral malaria. Pathogenesis of cerebral malaria is due to damaged vascular endothelium by parasite sequestration, inflammatory cytokine production and vascular leakage, which result in brain hypoxia, as indicated by increased lactate and alanine concentrations. The levels of the biomarkers’ histidine-rich protein II, angiopoietin-Tie-2 system and plasma osteoprotegrin serve as diagnostic and prognostic markers. Brain imaging may show neuropathology around the caudate and putamen. Mortality is high and patients who survive sustain brain injury which manifests as long-term neurocognitive impairments.

Keywords: cerebral malaria, neurologic manifestations, mortality, biomarkers, brain imaging

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