Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis
Abstract Background Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivit...
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ftdoajarticles:oai:doaj.org/article:22625471484a44928be542b272d58248 2023-05-15T15:13:25+02:00 Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis Tommaso Ascoli Bartoli Luciana Lepore Alessandra D’Abramo Giovanna Adamo Angela Corpolongo Laura Scorzolini Maria Letizia Giancola Nazario Bevilacqua Claudia Palazzolo Andrea Mariano Giuseppe Ippolito Pierre Buffet Emanuele Nicastri 2021-04-01T00:00:00Z https://doi.org/10.1186/s12936-021-03735-w https://doaj.org/article/22625471484a44928be542b272d58248 EN eng BMC https://doi.org/10.1186/s12936-021-03735-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03735-w 1475-2875 https://doaj.org/article/22625471484a44928be542b272d58248 Malaria Journal, Vol 20, Iss 1, Pp 1-8 (2021) Malaria Artemisinins Artesunate Hemolytic anemia Coombs test Drug-related side effects and adverse reactions Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-03735-w 2022-12-31T09:39:23Z Abstract Background Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT. Methods Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use. Results Twenty-two studies reporting 39 PADH cases were included: median baseline parasitaemia was 20.8% (IQR: 11.2–30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p = 0.01), had a higher baseline parasitaemia (27% vs 17%; p = 0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p = 0.002). Depth and kinetics of delayed anaemia were not associated with DAT positivity. Conclusions In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation suggests that DAT result may not be indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but it may be rather a marker of immune activation. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Malaria Artemisinins Artesunate Hemolytic anemia Coombs test Drug-related side effects and adverse reactions Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Artemisinins Artesunate Hemolytic anemia Coombs test Drug-related side effects and adverse reactions Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Tommaso Ascoli Bartoli Luciana Lepore Alessandra D’Abramo Giovanna Adamo Angela Corpolongo Laura Scorzolini Maria Letizia Giancola Nazario Bevilacqua Claudia Palazzolo Andrea Mariano Giuseppe Ippolito Pierre Buffet Emanuele Nicastri Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
topic_facet |
Malaria Artemisinins Artesunate Hemolytic anemia Coombs test Drug-related side effects and adverse reactions Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT. Methods Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use. Results Twenty-two studies reporting 39 PADH cases were included: median baseline parasitaemia was 20.8% (IQR: 11.2–30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p = 0.01), had a higher baseline parasitaemia (27% vs 17%; p = 0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p = 0.002). Depth and kinetics of delayed anaemia were not associated with DAT positivity. Conclusions In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation suggests that DAT result may not be indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but it may be rather a marker of immune activation. |
format |
Article in Journal/Newspaper |
author |
Tommaso Ascoli Bartoli Luciana Lepore Alessandra D’Abramo Giovanna Adamo Angela Corpolongo Laura Scorzolini Maria Letizia Giancola Nazario Bevilacqua Claudia Palazzolo Andrea Mariano Giuseppe Ippolito Pierre Buffet Emanuele Nicastri |
author_facet |
Tommaso Ascoli Bartoli Luciana Lepore Alessandra D’Abramo Giovanna Adamo Angela Corpolongo Laura Scorzolini Maria Letizia Giancola Nazario Bevilacqua Claudia Palazzolo Andrea Mariano Giuseppe Ippolito Pierre Buffet Emanuele Nicastri |
author_sort |
Tommaso Ascoli Bartoli |
title |
Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
title_short |
Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
title_full |
Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
title_fullStr |
Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
title_full_unstemmed |
Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
title_sort |
systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-03735-w https://doaj.org/article/22625471484a44928be542b272d58248 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-8 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-03735-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03735-w 1475-2875 https://doaj.org/article/22625471484a44928be542b272d58248 |
op_doi |
https://doi.org/10.1186/s12936-021-03735-w |
container_title |
Malaria Journal |
container_volume |
20 |
container_issue |
1 |
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1766343967156207616 |