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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15680

Title: Delayed haemolysis after artesunate treatment of severe malaria e Review of the literature and perspective
Authors: Agbenyega, Edward Tsiri
Rolling, Thierry
Krishna, Sanjeev
Kremsner, Peter G.
Cramer, Jakob P.
Keywords: Artemisinins;
Delayed haemolysis
Severe malaria;
Issue Date: 15-Feb-2015
Publisher: Elsevier Ltd
Citation: Elsevier Ltd, 2015
Abstract: Summary Artesunate has replaced quinine as the recommended first-line treatment of severe malaria as it clears parasites faster and lowers mortality. After artesunate’s introduction, however, reports of delayed haemolysis have emerged. Typically, this adverse haemolytic event peaks two to three weeks after the acute phase of malaria, and can be severe enough to make blood transfusions necessary in the management of some patients. Delayed haemolysis has been detected in prospective studies in 7e21% of patients treated with artesunate. A confirmed risk factor in travellers is hyperparasitaemia, while additional in malaria-endemic countries young age has been shown to increase risk. The pathophysiology of this phenomenon has not yet been fully elucidated, but may include various combinations of delayed destruction of “pitted” erythrocytes and autoimmune aetiology. All patients treated with parenteral artesunate should be followed up for at least four weeks to detect signs of haemolysis and to allow appropriate symptomatic treatment.
Description: This article is published at Elsevier Ltd, and also available at http://dx.doi.org/10.1016/j.tmaid.2015.03.003
URI: http://dx.doi.org/10.1016/j.tmaid.2015.03.003
Appears in Collections:College of Health Sciences

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