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Case Reports
. 2025 Jan 20;17(1):e77696.
doi: 10.7759/cureus.77696. eCollection 2025 Jan.

Revolutionizing Severe Malaria Management: The Role of CytoSorb® Hemoadsorption in Treating Malaria-Induced Liver Dysfunction

Rosanna Carmela De Rosa  1   2 , Antonio Romanelli  3 , Roberto Giurazza  4 , Fabrizio Falso  2 , Gianfranco Viola  1
Affiliations
Case Reports

Revolutionizing Severe Malaria Management: The Role of CytoSorb® Hemoadsorption in Treating Malaria-Induced Liver Dysfunction

Rosanna Carmela De Rosa et al. Cureus. .

Abstract

Malaria, caused by Plasmodium falciparum (PF), can lead to severe liver dysfunction and hyperbilirubinemia, worsening the prognosis. A 53-year-old male patient with malaria-related liver dysfunction and severe hyperbilirubinemia was treated with extracorporeal hemoadsorption (EHA) with the CytoSorb® filter (CytoSorbents, Monmouth Junction, NJ), marking a turning point in his treatment. This filter, by removing inflammatory mediators and bilirubin, significantly reduced bilirubin levels and improved the patient's clinical condition. This intervention facilitated a bridging therapy, improving symptoms and preventing organ damage during antimalarial treatment. CytoSorb® in EHA shows promise in treating malaria-induced liver dysfunction, suggesting the need for further research on its broader clinical application.

Keywords: case reports; cytosorb®; hemoadsorption; liver dysfunction; malaria.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Computed tomography scan
(A) The chest view shows bilateral pleural effusion. (B) The abdominal view shows perihepatic effusion, particularly in the subphrenic and paracolic regions. The pancreas is normal, showing no signs of inflammation, edema, or involvement in the pathological process.
Figure 2
Figure 2. Laboratory parameter trends
The figure shows the trends for CRP (A), direct bilirubin (B), and total bilirubin (C) over a six-day period. The application of CytoSorb® on the third to fifth days shows a marked decrease in total and direct bilirubin, as well as CRP, indicating the effectiveness of hemoadsorption technology in improving patient biochemical markers in severe malaria-induced liver dysfunction. CRP: C-reactive protein
Figure 3
Figure 3. Life cycle of Plasmodium parasite
The figure shows the complex life cycle of the Plasmodium parasite responsible for malaria. The cycle starts with bites of infected female Anopheles mosquitoes. Sporozoites infect hepatocytes, and after developing in the liver, merozoites are released and infect red blood cells, undergoing several stages of development before re-entering the mosquito upon blood meal. The cycle completes with the sexual reproduction stages in the mosquito's midgut, leading to the production of new sporozoites. The image is published under Creative Commons Attribution 4.0 International License (Simoiu et al. Cells 2023, doi.org/10.3390/cells12172156).
Figure 4
Figure 4. Setup of the CytoSorb® hemoadsorption system
The figure shows the setup of the CytoSorb® hemoadsorption system used for removing toxins from the blood. Blood is drawn from the patient using a pump and passed through the CytoSorb® filter where toxins are adsorbed. The cleaned blood then passes through a bubble catcher to ensure safety before being returned to the patient. The image is published under Creative Commons Attribution 4.0 International License (Mair et al. Journal of Cardiothoracic Surgery 2024, doi.org/10.1186/s13019-024-02772-1).
See this image and copyright information in PMC

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