Plasmodium vivax with acute glomerulonephritis in an 8- year old--queries.

(1) The patient described in the case was having severe manifestations of vivax malaria. In addition to severe thrombocytopenia, he also had renal dysfunction, hypotension and hemolysis. The authors have diagnosed glomerulonephritis on the basis of presence of hematuria and hypertension. However, hematuria in the patient could have been due to severe thrombocytopenia or malariainduced renal ischemia and acute tubular necrosis. The presence of brown or cola coloured urine with red blood cell casts (RBC) and deformed RBCs confirms the glomerular origin of hematuria2. Although the presence of heavy proteinuria suggests a glomerular origin, it would have been helpful if the authors had also commented on the presence of red blood cell casts (RBC) and deformed RBCs in the urine.