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Free Content Pentoxifylline adjunct improves prognosis of human cerebral malaria in adults

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Summary

Fifty-two adult patients with cerebral malaria were randomly categorized into two groups to receive either quinine dihydrochloride (Qn) alone or a combination of Qn and pentoxifylline (Px). Thirty-two of them received intravenous (i.v.) Qn (group I), and 20 patients (group II) received i.v. Qn along with parenteral Px support (10 mg/kg/day) for the initial 3 days. There was significant improvement in coma resolution time in group II (21.6 ± 13.9 h) in comparison with group I (63.5 ± 19.7 h) (P < 0.001), and mortality was 25% of patients in group I against 10% patients receiving Px adjunct (P > 0.05). Three days post-therapy, serum tumour necrosis factor-α (TNF-α) levels decreased significantly in patients on Px support (day 0 TNF = 415.62 ± 477.80 pg/ml; day 3 TNF = 47.92 ± 27.9 pg/ml; P = 0.0029). There was no significant change in TNF levels in those on quinine alone (day 0 TNF = 477.08 ± 933.90 pg/ml; day 3 TNF = 589 ± 602.3 pg/ml; P > 0.05). There were no serious side-effects necessitating withdrawal of patients receiving Px therapy.
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Keywords: Plasmodium falciparum; human cerebral malaria; pentoxifylline; quinine dihydrochloride; tumour necrosis factor-α

Document Type: Research Article

Affiliations: 1: Department of Internal Medicine, S.C.B. Medical College, Cuttack, India 2: Department of Biochemistry, S.C.B. Medical College, Cuttack, India 3: Division of Immunology, Regional Medical Research Center, Bhubaneswar, India

Publication date: 2003-08-01

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