Skip to main content
SpringerLink
Log in

Human liver biopsy inP. falciparum andP. vivax malaria

A light and electron microscopy study

Bioptische Befunde der Leber bei menschlicher P.-falciparum- und P.-vivax-Malaria

Eine licht- und elektronenmikroskopische Studie

  • Published:
Virchows Archiv A Aims and scope Submit manuscript

Zusammenfassung

Die Leberpunktate von 5 Patienten mit Plasmodium-vivax- und 1 Patienten mit Plasmodium-falciparum-Malaria zeigen nur unspezifische Veränderungen am endoplasmatischen Retikulum und den Mitochondrien der Leberzellen. An den Sinusoiden zugekehrten Leberzellgrenzen wird eine Verarmung und/oder Deformierung der Mikrovilli mit Schwellung der Endothelien gesehen.

Die Kupfferschen Sternzellen sind hyperplastisch und hypertrophisch und weisen eine lebhafte Phagozytosetätigkeit auf. Sie enthalten parasitisierte und parasitenfreie Erythrozyten. Es wird vermutet, daß die Alteration der Sinusoidgrenzen der Leberzellen einen verminderten Stoffaustausch zwischen Leberzellen und Blutstrom zur Folge hat.

In den Sinusoiden finden sich häufig miteinander verklumpte parasitisierte und parasitenfreie Erythrozyten. Sie werden als Ausdruck eines gestörten Koagulations- und/oder immunologischen Prozesses gewertet. Die örtlichen Zirkulationsstörungen sind nur Teil eines übergeordneten pathogenetischen Mechanismus, durch welchen ein hypoxischer hepatozellulärer Schaden bedingt wird.

Summary

Liver biopsy, in one patient withP. falciparum and in five patients withP. vivax malaria revealed non-specific hepatocellular damage chracterized by pathologic changes of the endoplasmic reticulum and mitochondria. Also the sinusoidal pole of hepatic cells was altered mainly by depletion of microvilli and/or distortion and swelling of the endothelial cells. Von Kupffer cells were hyperplastic and hypertrophic and exhibited considerable phagocytic activity for both parasitized and non-parasitized erythrocytes. It is believed that the altered sinusoidal pole causes a deficient exchange between the hepatic cells and the blood stream.

Clumped parasitized and non-parasitized erythrocytes were frequently observed in the sinusoids, a finding that could be interpreted as the manifestation of a disturbed coagulation process and/or an immunological mechanism in progress. This local circulatory disturbance is only part of a more general pathogenetic mechanism through which hepatocellular hypoxemic damage would be produced.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Aikawa, M., Huff, C. G., Sprinz, H.: Comparative feeding mechanism of avian and primate malarial parasites. Milit. Med., Suppl.131, 969–983 (1966).

    Google Scholar 

  • Andrews, W. H. H.: The liver lesions in malaria. Trans. roy. Soc. trop. Med. Hyg.41, 699–704 (1948).

    Google Scholar 

  • Brito, T., Meira, J. A., Bassoi, O. N.: Contribuição ao estudo da malaria. II. Patologia do fígado na malária aguda. Rev. Inst. Med. trop. S. Paulo4, 105–111 (1962).

    Google Scholar 

  • Corcoran, T. E., Hegstrom, G. J., Zoeckler, S. J., Keil, P. G.: Liver structure in non fatal malaria. Gastroenterology24, 53–62 (1953).

    Google Scholar 

  • Dennis, L. H., Eichelberger, J. W., Doenhoft, A. E., Conrad, M. E.: A coagulation defect and its treatment with heparin inPlasmodium knowlesi Malaria in Rhesus monkeys. Milit. Med. Suppl.131, 1107–1114 (1966).

    Google Scholar 

  • Desowitz, R. S. (rapporteur): The comparative phathophysiology of malaria. Report of a Symposium held at the School of Tropical Medicine, Bangkok, August 9th, 1967. Ann. trop. Med. Parasit.61, 515–518 (1967).

    Google Scholar 

  • Dixon, F. J.: Comments on Immunopathology (Malaria). Milit. Med., Suppl.131, 1233–1234 (1966).

    Google Scholar 

  • Fletcher, K. A., Maegraith, B. G.: Some aspects of the pathogenesis of malaria. Bull. Soc. Path. exot.,59, 526–532 (1966).

    Google Scholar 

  • Jervis, H. R., Mac Callum, D. K., Sprinz, H.: ExperimentalPlasmodium berghei infection in the hamster: its effect on the liver. Arch. Path.86, 328–337 (1968).

    Google Scholar 

  • Knisely, M. H.: Correspondence to the Editor. J. Amer. med. Ass.121, 885 (1943).

    Google Scholar 

  • —— Stratman-Thomas, W. K., Eliot, T. S.: Observations on circulating blood in the small vessels of internal organs in livingMacacus rhesus infected with malarial parasites. Anat. Rec., Suppl.79, 90 (1941).

    Google Scholar 

  • Ladda, R., Arnold, J., Martin, D.: Electron microscopy ofPlasmodium falciparum. I. The structure of trophozoites in erythrocytes of human volunteers. Trans. roy. Soc. trop. Med. Hyg.60, 369–375 (1966).

    Google Scholar 

  • Maegraith, B.: Pathological processes in Malaria. Trans. roy. Soc. trop. Med. Hyg.41, 687–699 (1948).

    Google Scholar 

  • —— Pathological processes in Malaria and blackwater fewer. Springfield: Ch. C. Thomas 1948.

    Google Scholar 

  • McMahon, A. E., Derauf, D. E.: Hepatitis of malarial origin: clinical and pathologic study of 54 Korean veterans. Arch. intern. Med.93, 379–386 (1954).

    Google Scholar 

  • Miwa, S., Tanikawa, K.: Electron microscopic observation of the liver in Malaria and Kala azar. Rev. Int. Hepat.15, 489–496 (1965).

    Google Scholar 

  • Rosen, S., Hano, J. E., Inman, M. M., Gillilano, P. F., Barry, K. G.: The kidney in blackwater fewer: light and electron microscopic observations. Amer. J. clin. Path.49, 358–370 (1968).

    Google Scholar 

  • —— Roycroft, D., Hano, M. J. E., Barry, K. G.: The liver in malaria: electron microscopic observations on a hepatic biopsy obtained 15 minutes post mortem. Arch. Path.83, 271–277 (1967).

    Google Scholar 

  • Schaffner, F.: Ultrastructural changes in the liver in acute viral hepatitis. In: Vandenbroucke, J., J. de Groote, and L. O. Standaert, ed., Liver research. Trans. IIIrd Internat. Symposium Internat. Assoc. Study of Liver p. 1–2, Tokyo, September 1963.

  • Skirrow, M.., Chongsuphajaisiddhi, T., Maegraith, B. G.: The circulation in malaria. II. Portal angiography in monkeys (Macaca mulatta) infected withPlasmodium knowlesi and in shock following manipulation of the gut. Ann. trop. Med. Parasit.58, 502–510 (1964).

    Google Scholar 

  • Tanikawa, K.: Ultrastructural aspects of the liver and its disorders. Tokyo: Iguku Shoin 1968.

    Google Scholar 

  • Telcharov, L., Todorowa, M.: Le foie des paludéens (étudié sur 45 cas au moyen de ponctions biopsies). Sem. Hôp. Paris26, 2072–2075 (1950).

    Google Scholar 

  • Trager, W., Rudzinska, M. A., Bradbury, P. C.: The fine structure ofPlasmodium falciparum and its host erythrocytes in natural malarial infections in man. Bull. Wld. Hlth. Org.35, 883–885 (1966).

    Google Scholar 

  • White, L., Doerner, A. A.: Functional and needle biopsy study of the liver in malaria. J. Amer. med. Ass.115, 637–639 (1954).

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Instituto de Medicina Tropical de S. Paulo, Brazil

    T. de Brito, A. A. Barone & R. M. Faria

Authors
  1. T. de Brito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. A. Barone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. M. Faria
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This paper was supported by grants of the “IBEPEGE” and “FAPESP”.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Brito, T., Barone, A.A. & Faria, R.M. Human liver biopsy inP. falciparum andP. vivax malaria. Virchows Arch. Abt. A Path. Anat. 348, 220–229 (1969). https://doi.org/10.1007/BF00555648

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00555648

Keywords

Search

Navigation