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Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria

Malaria is still an endemic disease in Africa, with many imported cases in Europe. The standard treatment is intravenous artesunate for severe malaria and oral artemisinin-based combination therapy (ACT) for uncomplicated malaria. Delayed hemolytic anemia (DHA) after intravenous artesunate has been...

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Autores principales: Louvois, Marion, Simon, Loïc, Pomares, Christelle, Jeandel, Pierre-Yves, Demonchy, Elisa, Carles, Michel, Delaunay, Pascal, Courjon, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801417/
https://www.ncbi.nlm.nih.gov/pubmed/35111773
http://dx.doi.org/10.3389/fmed.2021.756050
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author Louvois, Marion
Simon, Loïc
Pomares, Christelle
Jeandel, Pierre-Yves
Demonchy, Elisa
Carles, Michel
Delaunay, Pascal
Courjon, Johan
author_facet Louvois, Marion
Simon, Loïc
Pomares, Christelle
Jeandel, Pierre-Yves
Demonchy, Elisa
Carles, Michel
Delaunay, Pascal
Courjon, Johan
author_sort Louvois, Marion
collection PubMed
description Malaria is still an endemic disease in Africa, with many imported cases in Europe. The standard treatment is intravenous artesunate for severe malaria and oral artemisinin-based combination therapy (ACT) for uncomplicated malaria. Delayed hemolytic anemia (DHA) after intravenous artesunate has been extensively described, and guidelines recommend biological monitoring until 1 month after the end of the treatment. A link with an autoimmune process is still unsure. Nevertheless, cases with positive direct antiglobulin test (DAT) have been reported. Conversely, DHA is not recognized as an adverse effect of oral ACT. Previously, only few cases of DHA occurring after oral ACT without intravenous artesunate administration have been reported. We report the case of a 42-year-old man returning from Togo. He was treated with dihydroartemisinin/piperaquine combination for uncomplicated Plasmodium falciparum malaria, with low parasitemia. Nine days after the end of the treatment, the patient developed hemolytic anemia with positive DAT. Eventually, the patient recovered after corticotherapy. After excluding common causes of autoimmune hemolytic anemia, we considered that dihydroartemisinin/piperaquine treatment was involved in this side effect.
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spelling pubmed-88014172022-02-01 Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria Louvois, Marion Simon, Loïc Pomares, Christelle Jeandel, Pierre-Yves Demonchy, Elisa Carles, Michel Delaunay, Pascal Courjon, Johan Front Med (Lausanne) Medicine Malaria is still an endemic disease in Africa, with many imported cases in Europe. The standard treatment is intravenous artesunate for severe malaria and oral artemisinin-based combination therapy (ACT) for uncomplicated malaria. Delayed hemolytic anemia (DHA) after intravenous artesunate has been extensively described, and guidelines recommend biological monitoring until 1 month after the end of the treatment. A link with an autoimmune process is still unsure. Nevertheless, cases with positive direct antiglobulin test (DAT) have been reported. Conversely, DHA is not recognized as an adverse effect of oral ACT. Previously, only few cases of DHA occurring after oral ACT without intravenous artesunate administration have been reported. We report the case of a 42-year-old man returning from Togo. He was treated with dihydroartemisinin/piperaquine combination for uncomplicated Plasmodium falciparum malaria, with low parasitemia. Nine days after the end of the treatment, the patient developed hemolytic anemia with positive DAT. Eventually, the patient recovered after corticotherapy. After excluding common causes of autoimmune hemolytic anemia, we considered that dihydroartemisinin/piperaquine treatment was involved in this side effect. Frontiers Media S.A. 2022-01-17 /pmc/articles/PMC8801417/ /pubmed/35111773 http://dx.doi.org/10.3389/fmed.2021.756050 Text en Copyright © 2022 Louvois, Simon, Pomares, Jeandel, Demonchy, Carles, Delaunay and Courjon. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Louvois, Marion
Simon, Loïc
Pomares, Christelle
Jeandel, Pierre-Yves
Demonchy, Elisa
Carles, Michel
Delaunay, Pascal
Courjon, Johan
Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria
title Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria
title_full Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria
title_fullStr Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria
title_full_unstemmed Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria
title_short Case Report: Autoimmune Hemolysis Anemia After Dihydroartemisinin and Piperaquine for Uncomplicated Plasmodium falciparum Malaria
title_sort case report: autoimmune hemolysis anemia after dihydroartemisinin and piperaquine for uncomplicated plasmodium falciparum malaria
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801417/
https://www.ncbi.nlm.nih.gov/pubmed/35111773
http://dx.doi.org/10.3389/fmed.2021.756050
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