Severe delayed autoimmune haemolytic anaemia following artesunate administration in severe malaria: a case report
| Autor: | Mathilde Beguet, T. Pistone, Denis Malvy, Loic Raffray, Marie-Catherine Receveur, Pierre Lauroua |
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| Přispěvatelé: | Unités maladies tropicales et du voyageur, CHU Bordeaux [Bordeaux]-Hôpital Saint-André - Bordeaux, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Etablissement de Transfusion Sanguine - Site Pellegrin 1 (EFS AQLI - Site Pellegrin 1), Groupe hospitalier Pellegrin, Unité tropicale 4ème Aile 1&3, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin (Bordeaux), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, Dupuis, Christine |
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
Adolescent Anemia Artesunate Case Report Lumefantrine Antimalarials Severe malaria chemistry.chemical_compound Autoimmune haemolytic anaemia [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Internal medicine medicine Humans Artemether Malaria Falciparum Side effects Septic shock business.industry medicine.disease Haemolysis Artemisinins 3. Good health Cote d'Ivoire Infectious Diseases chemistry Immunology [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases Ceftriaxone Female Parasitology Anemia Hemolytic Autoimmune France business Malaria medicine.drug |
| Zdroj: | Malaria Journal Malaria Journal, BioMed Central, 2014, 13, pp.398. ⟨10.1016/S0035-9203(03)90079-4⟩ |
| ISSN: | 1475-2875 |
| DOI: | 10.1186/1475-2875-13-398 |
| Popis: | Background Parenteral artesunate is recommended as first-line therapy for severe and complicated malaria. Although its efficacy has been proven, long-term safety profile is still under evaluation. Several cases of delayed haemolytic anaemia occurred after initial clinical improvement and resolution of parasitaemia in non-immune travellers and children living in endemic areas. Reports have generated concern that this phenomenon might be related to the treatment itself, either by direct toxicity or immune-related mechanism. This is a report of the first case of autoimmune haemolytic anaemia following treatment of severe malaria initially managed with parenteral artesunate with strong indication for drug-immune related mechanism. Case A 17-year old Ivoirian female travelling in France presented with fever, headache and abdominal pain seven days after her arrival. Physical examination was indicative of septic shock while blood analysis showed normal haemoglobin level, but profound thrombocytopaenia and hyperlactataemia. Blood smear analysis showed Plasmodium falciparum infection with a parasitaemia of 0.8%. Severe malaria was diagnosed according to the WHO criteria. The patient was initially managed with artemether/lumefantrine combination and then parenteral artesunate for 48 hours. Empiric antibiotic course was also initiated with ceftriaxone, metronidazole, gentamycin, and then piperacillin and ciprofloxacin. At day 14, haemoglobin dropped to 4.6 g/dL with biologic features indicative of haemolysis (LDH 658 U/L, haptoglobin |
| Databáze: | OpenAIRE |
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