Delayed-Onset Hemolytic Anemia in Patients with Travel-Associated Severe Malaria Treate... - 0 views
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delayed hemolytic events occur in ≈20% of patients with severe imported malaria, and 60% of these patients require blood transfusion
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Delayed-onset anemia (herein referred to as postartesunate delayed-onset hemolysis [PADH] pattern of anemia) has been observed to occur 2–3 weeks after initiation of IV artesunate
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The mechanism of this anemia is hemolytic, as demonstrated by high serum lactate dehydrogenase (LDH) and low plasma haptoglobin levels
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PADH occurred in 27% of patients in this study, but it was rarely associated with severe anemia and was never fatal
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This transfusion rate (<5%) is markedly lower than that previously reported for patients with severe imported malaria and delayed-onset anemia (≈60%)
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Side effects of artesunate frequently include gastrointestinal disturbances, neutropenia (1.3%), reticulocytopenia (0.6%), and elevated liver enzymes (1.1%)