The impact of using primaquine without prior G6PD testing: a case series describing the obstacles to the medical management of haemolysis
| Autor: | Verena I. Carrara, Cindy S. Chu, Nay Lin Soe, Gornpan Gornsawun, Germana Bancone, François Nosten |
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| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities Primaquine 030231 tropical medicine Plasmodium vivax Medicine (miscellaneous) General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine G6PD deficiency hemic and lymphatic diseases parasitic diseases Medicine 030212 general & internal medicine Dosing Medical prescription Clinical Practice Article Adverse effect biology business.industry Haemolysis nutritional and metabolic diseases Articles medicine.disease biology.organism_classification 3. Good health Regimen business Malaria medicine.drug |
| Zdroj: | Wellcome Open Research |
| Popis: | Radical cure of Plasmodium vivax malaria in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals employs weekly primaquine dosing. This is the only recommended regimen for this patient sub-group. If national malaria programs mandate daily primaquine dosing (the recommended regimen for G6PD normal individuals), then G6PD testing before prescription is necessary to avoid iatrogenic haemolysis in G6PD deficient individuals. In this case series, two P. vivax infected patients with unknown G6PD status from two different countries were prescribed primaquine as per national malaria program guidelines. During treatment both patients presented to the clinic with symptoms of anaemia after taking primaquine incorrectly. The clinical management of the iatrogenic severe haemolysis that occurred in these patients demonstrates the various adverse effects primaquine can cause, that other common medical treatments also have haemolytic potential, and how the diagnosis of G6PD deficiency can be elusive during acute haemolysis. Health care providers should provide careful instructions about primaquine dosing, be watchful for haemolysis, and have a high index of suspicion for G6PD deficiency in the presence of haemolysis if the G6PD status is previously unknown. |
| Databáze: | OpenAIRE |
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