Liver Function Tests in Chronic Relapsing Vivax Malaria.

Hepatic function in chronic relapsing malaria caused by Plasmodium vivax and treated principally by atabrine has been investigated at Harmon General Hospital in 317 soldiers. This study seemed advisable because of previous reports that impairment of liver function may occur in both naturally-acquired (1 to 3) and induced malaria (4). Several types of tests were performed on our patients both during recurrent attacks and at various intervals afterwards. Most of these same tests were also performed on healthy individuals to determine whether in our laboratory the methods gave normal ranges of values corresponding to those found in the literature. This made it possible to compare the findings in our patients with those of our healthy control series, as well as with the results of other investigators. The liver function tests used may be grouped roughly into 3 categories: (a) those in which hepatic dysfunction is suspected when abnormal values are found-bromsulfalein, cephalin flocculation, galactose tolerance and hippuric acid tests; (b) those in which an abnormal value may be associated with increased red blood cell destruction and/or hepatic dysfunction-icterus index, serum bilirubin concentration, and urine urobilinogen concentration; and (c) quantitative determinations of some constituents of blood serum occasionally found to yield abnormal results in persons with hepatic disease-albumin, globulin, total protein, cholesterol and phosphatase.