The transcapillary escape rate and capillary permeability of fibrinogen were studied in 7 patients wih Plasmodium falciparum malaria and 4 control subjects by using 131I-fibrinogen as a tracer. The plasma disappearance curve of 131I-fibrinogen was followed during the first 60 minutes after injection. The mean transcapillary rate of fibrinogen in these patients was found to be significantly higher than that of the control group. As the plasma volume and fibrinogen concentrations were grossly elevated in these patients, this resulted in a significantly higher plasma clearance, intravascular pool of fibrinogen and out-flux of fibrinogen from the intravascular to the extravascular compartments. Both the effective capillary pore area per unit path length available for restricted diffusion and the specific permeability coefficient of plasma fibrinogen were increased in the patients group which indicated that the increased leakage of fibrinogen was due to the increased surface area of capillary membrane and an increased capillary permeability to fibrinogen. The mean extravascular transit time for fibrinogen to return to plasma via the lymph was slightly, but not significantly shorter in the patients group than the control group. All these findings indicated that there was an increased capillary permeability in patients with P. falciparum malaria which resulted in the increased leakage of plasma fibrinogen from the circulation into the extravascular space.
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