Renal Cortical Necrosis: An Unusual Complication of Plasmodium malariae Malaria

Ahmed Tall Lemrabott¹, Mouhamadou Moustapha Cissé¹, Sidy Mohamed Seck², Elhadji Fary Ka¹, Maria Faye¹, Aliou Ndongo¹, Cherif Dial³, Younoussa Keita¹, Khodia Fall¹, Abdou Niang¹, Boucar Diouf¹

¹Department of Nephrology, Aristide Le Dantec University Hospital, Dakar, Senegal.
²Faculty of Medicine, Gaston Berger University, Saint-Louis, Senegal.
³Anatomo-Pathology Laboratory, Grand-Yoff General Hospital, Dakar, Senegal.

DOI: 10.4236/ojneph.2015.54015                

Abstract

Renal cortical necrosis (RCN) is anecdotal in malaria. To our knowledge, RCN secondary to Plasmodium malariae has not yet been published. We report a case of severe malaria complicated by RCN. A 29 year old Senegalese patient was transferred to our department for anuria in a context of severe malaria. The diagnosis was RCN secondary to a severe Plasmodium malariae malaria. Physical examination showed anuria, anaemic syndrome, haemorrhagic syndrome and a generally impaired condition. There was a normocytic normochromic anaemia aplastic, thrombocytopenia leukocytosis of 11.580/mm³, serum creatinine of 12.45 mg/dl and blood urea of 252 mg/dl. The Plasmodium malariae had been shown to thick blood film with high parasite density. The molecular study was able to confirm the infestation of this parasite. Treatment consisted of four haemodialysis sessions and antimalarial molecules. Initial evolution was favourable with a recovery through diuresis and a partial improvement in renal function. Given the persistence of impaired renal function, a renal biopsy was performed. This confirmed the RCN. At last consultation, he had no symptoms and his last glomerular filtration rate (GFR) was 30 mL/min/1.73 m².

Keywords

Renal Cortical Necrosis, Plasmodium malariae, Acute Kidney Injury, Malaria

Conflicts of Interest

The authors declare no conflicts of interest.

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