Artesunate-induced severe autoimmune hemolytic anemia in complicated malaria.

Autor:	Singh, Sarvinder, Singh, Santosh, Tentu, Ajai, Kumar, Anshu, Shahbabu, Bhaskar, Singh, Vani, Singh, Nidhi
Předmět:	ADRENOCORTICAL hormones ANTIMALARIALS AUTOIMMUNE diseases BLOOD transfusion COOMBS' test FEVER HEMOGLOBINS HEMOLYTIC anemia MALARIA MIXED infections DISEASE complications THERAPEUTICS
Zdroj:	Indian Journal of Critical Care Medicine; Oct2018, Vol. 22 Issue 10, p753-756, 4p, 2 Color Photographs, 4 Graphs
Abstrakt:	Autoimmune hemolytic anemia (AIHA) is a very rare cause of anemia in a case of malaria and drug-induced AIHA is even rarer. A 50-year old patient with a history of fever for 8 days was diagnosed with a case of complicated malaria with mixed infection having initial parasite index of 45%. He showed good response on initial therapy with artesunate (parasite count reduced to <1%) but his haemoglobin (Hb) continued to drop from 12 g% to 4.9 g% over a course of 11 days. Direct coombs test was positive with reduced haptoglobin and increased lactate dehydrogenase suggesting AIHA. The patient was put on steroids and transfused with saline washed O-negative blood. He gradually recovered over 8 weeks with Hb level rising up to 12 g%. This is a rare case of AIHA following treatment of severe malaria with parenteral artesunate suggesting of the drug immune-related mechanism. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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