Cargando…

Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria

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 g...

Descripción completa

Detalles Bibliográficos
Autores principales: Singh, Sarvinder, Singh, Santosh Kumar, Tentu, Ajai Kumar, Kumar, Anshu, Shahbabu, Bhaskar, Singh, Vani, Singh, Nidhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201652/
https://www.ncbi.nlm.nih.gov/pubmed/30405291
http://dx.doi.org/10.4103/ijccm.IJCCM_298_18
_version_ 1783365552428810240
author Singh, Sarvinder
Singh, Santosh Kumar
Tentu, Ajai Kumar
Kumar, Anshu
Shahbabu, Bhaskar
Singh, Vani
Singh, Nidhi
author_facet Singh, Sarvinder
Singh, Santosh Kumar
Tentu, Ajai Kumar
Kumar, Anshu
Shahbabu, Bhaskar
Singh, Vani
Singh, Nidhi
author_sort Singh, Sarvinder
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6201652
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-62016522018-11-07 Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria Singh, Sarvinder Singh, Santosh Kumar Tentu, Ajai Kumar Kumar, Anshu Shahbabu, Bhaskar Singh, Vani Singh, Nidhi Indian J Crit Care Med Case Report 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. Medknow Publications & Media Pvt Ltd 2018-10 /pmc/articles/PMC6201652/ /pubmed/30405291 http://dx.doi.org/10.4103/ijccm.IJCCM_298_18 Text en Copyright: © 2018 Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Singh, Sarvinder
Singh, Santosh Kumar
Tentu, Ajai Kumar
Kumar, Anshu
Shahbabu, Bhaskar
Singh, Vani
Singh, Nidhi
Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria
title Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria
title_full Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria
title_fullStr Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria
title_full_unstemmed Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria
title_short Artesunate-Induced Severe Autoimmune Hemolytic Anemia in Complicated Malaria
title_sort artesunate-induced severe autoimmune hemolytic anemia in complicated malaria
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201652/
https://www.ncbi.nlm.nih.gov/pubmed/30405291
http://dx.doi.org/10.4103/ijccm.IJCCM_298_18
work_keys_str_mv AT singhsarvinder artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria
AT singhsantoshkumar artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria
AT tentuajaikumar artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria
AT kumaranshu artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria
AT shahbabubhaskar artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria
AT singhvani artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria
AT singhnidhi artesunateinducedsevereautoimmunehemolyticanemiaincomplicatedmalaria