Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine
Abstract Intravenous (i.v.) artesunate is now the recommended first-line treatment of severe falciparum malaria in adults and children by WHO guidelines. Nevertheless, several cases of haemolytic anaemia due to i.v. artesunate treatment have been reported. This paper describes the case of an HIV-inf...
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ftdoajarticles:oai:doaj.org/article:b0f39a5fbdf240a4bef6a6717ea4ae78 2023-05-15T15:12:17+02:00 Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine Corpolongo Angela De Nardo Pasquale Ghirga Piero Gentilotti Elisa Bellagamba Rita Tommasi Chiara Paglia Maria Nicastri Emanuele Narciso Pasquale 2012-03-01T00:00:00Z https://doi.org/10.1186/1475-2875-11-91 https://doaj.org/article/b0f39a5fbdf240a4bef6a6717ea4ae78 EN eng BMC http://www.malariajournal.com/content/11/1/91 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-11-91 1475-2875 https://doaj.org/article/b0f39a5fbdf240a4bef6a6717ea4ae78 Malaria Journal, Vol 11, Iss 1, p 91 (2012) Severe malaria Artemisinin-based combination therapy (ACT) Haemolytic anaemia Drugs and haemolytic anaemia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2012 ftdoajarticles https://doi.org/10.1186/1475-2875-11-91 2022-12-31T08:43:49Z Abstract Intravenous (i.v.) artesunate is now the recommended first-line treatment of severe falciparum malaria in adults and children by WHO guidelines. Nevertheless, several cases of haemolytic anaemia due to i.v. artesunate treatment have been reported. This paper describes the case of an HIV-infected patient with severe falciparum malaria who was diagnosed with haemolytic anaemia after treatment with oral artemether-lumefantrine. The patient presented with fever, headache, and arthromyalgia after returning from Central African Republic where he had been working. The blood examination revealed acute renal failure, thrombocytopaenia and hypoxia. Blood for malaria parasites indicated hyperparasitaemia (6%) and Plasmodium falciparum infection was confirmed by nested-PCR. Severe malaria according to the laboratory WHO criteria was diagnosed. A treatment with quinine and doxycycline for the first 12 hours was initially administered, followed by arthemeter/lumefantrine (Riamet ® ) for a further three days. At day 10, a diagnosis of severe haemolytic anaemia was made (Hb 6.9 g/dl, LDH 2071 U/l). Hereditary and autoimmune disorders and other infections were excluded through bone marrow aspiration, total body TC scan and a wide panel of molecular and serologic assays. The patient was treated by transfusion of six units of packed blood red cell. He was discharged after complete remission at day 25. At present, the patient is in a good clinical condition and there is no evidence of haemolytic anaemia recurrence. This is the first report of haemolytic anaemia probably associated with oral artemether/lumefantrine. Further research is warranted to better define the adverse events occurring during combination therapy with artemisinin derivatives. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 11 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Severe malaria Artemisinin-based combination therapy (ACT) Haemolytic anaemia Drugs and haemolytic anaemia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Severe malaria Artemisinin-based combination therapy (ACT) Haemolytic anaemia Drugs and haemolytic anaemia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Corpolongo Angela De Nardo Pasquale Ghirga Piero Gentilotti Elisa Bellagamba Rita Tommasi Chiara Paglia Maria Nicastri Emanuele Narciso Pasquale Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
topic_facet |
Severe malaria Artemisinin-based combination therapy (ACT) Haemolytic anaemia Drugs and haemolytic anaemia Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Intravenous (i.v.) artesunate is now the recommended first-line treatment of severe falciparum malaria in adults and children by WHO guidelines. Nevertheless, several cases of haemolytic anaemia due to i.v. artesunate treatment have been reported. This paper describes the case of an HIV-infected patient with severe falciparum malaria who was diagnosed with haemolytic anaemia after treatment with oral artemether-lumefantrine. The patient presented with fever, headache, and arthromyalgia after returning from Central African Republic where he had been working. The blood examination revealed acute renal failure, thrombocytopaenia and hypoxia. Blood for malaria parasites indicated hyperparasitaemia (6%) and Plasmodium falciparum infection was confirmed by nested-PCR. Severe malaria according to the laboratory WHO criteria was diagnosed. A treatment with quinine and doxycycline for the first 12 hours was initially administered, followed by arthemeter/lumefantrine (Riamet ® ) for a further three days. At day 10, a diagnosis of severe haemolytic anaemia was made (Hb 6.9 g/dl, LDH 2071 U/l). Hereditary and autoimmune disorders and other infections were excluded through bone marrow aspiration, total body TC scan and a wide panel of molecular and serologic assays. The patient was treated by transfusion of six units of packed blood red cell. He was discharged after complete remission at day 25. At present, the patient is in a good clinical condition and there is no evidence of haemolytic anaemia recurrence. This is the first report of haemolytic anaemia probably associated with oral artemether/lumefantrine. Further research is warranted to better define the adverse events occurring during combination therapy with artemisinin derivatives. |
format |
Article in Journal/Newspaper |
author |
Corpolongo Angela De Nardo Pasquale Ghirga Piero Gentilotti Elisa Bellagamba Rita Tommasi Chiara Paglia Maria Nicastri Emanuele Narciso Pasquale |
author_facet |
Corpolongo Angela De Nardo Pasquale Ghirga Piero Gentilotti Elisa Bellagamba Rita Tommasi Chiara Paglia Maria Nicastri Emanuele Narciso Pasquale |
author_sort |
Corpolongo Angela |
title |
Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
title_short |
Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
title_full |
Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
title_fullStr |
Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
title_full_unstemmed |
Haemolytic anaemia in an HIV-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
title_sort |
haemolytic anaemia in an hiv-infected patient with severe falciparum malaria after treatment with oral artemether-lumefantrine |
publisher |
BMC |
publishDate |
2012 |
url |
https://doi.org/10.1186/1475-2875-11-91 https://doaj.org/article/b0f39a5fbdf240a4bef6a6717ea4ae78 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 11, Iss 1, p 91 (2012) |
op_relation |
http://www.malariajournal.com/content/11/1/91 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-11-91 1475-2875 https://doaj.org/article/b0f39a5fbdf240a4bef6a6717ea4ae78 |
op_doi |
https://doi.org/10.1186/1475-2875-11-91 |
container_title |
Malaria Journal |
container_volume |
11 |
container_issue |
1 |
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1766342994895568896 |