Delayed-Onset Hemolytic Anemia in Patients with Travel-Associated Severe Malaria Treated with Artesunate, France, 2011-2013

被引：51

作者：

Jaureguiberry, Stephane ^{[1
,2
,3
]}

Thellier, Marc ^{[1
,2
,3
]}

Ndour, Papa Alioune ^{[1
]}

Ader, Flavie ^{[2
]}

Roussel, Camille ^{[1
]}

Sonneville, Romain ^{[4
]}

Mayaux, Julien ^{[2
]}

Matheron, Sophie ^{[4
]}

Angoulvant, Adela ^{[5
,6
]}

Wyplosz, Benjamin ^{[6
]}

Rapp, Christophe ^{[7
]}

Pistone, Thierry ^{[8
]}

Lebrun-Vignes, Benedicte ^{[2
]}

Kendjo, Eric ^{[3
]}

Danis, Martin ^{[1
,2
,3
]}

Houze, Sandrine ^{[4
]}

Bricaire, Francois ^{[2
]}

Mazier, Dominique ^{[1
,2
,3
]}

Buffet, Pierre ^{[1
,2
,3
]}

Caumes, Eric ^{[1
,2
]}

机构：

[1] Univ Paris 06, Paris, France

[2] Hop La Pitie Salpetriere, AP HP, F-75013 Paris, France

[3] Ctr Natl Reference Paludisme, Paris, France

[4] Hop Bichat Claude Bernard, AP HP, F-75877 Paris, France

[5] Univ Paris 11, Orsay, France

[6] Hop Bicetre, AP HP, Le Kremlin Bicetre, France

[7] Hosp Instruct Armees Begin, St Mande, France

[8] Hop Pellegrin, F-33076 Bordeaux, France

来源：

EMERGING INFECTIOUS DISEASES | 2015年 / 21卷 / 05期

关键词：

SEVERE FALCIPARUM-MALARIA; SEVERE IMPORTED MALARIA; INTRAVENOUS ARTESUNATE; AFRICAN CHILDREN; QUININE;

D O I：

10.3201/eid2105.141171

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Artesunate is the most effective treatment for severe malaria. However, delayed-onset hemolytic anemia has been observed in approximate to 20% of travelers who receive artesunate, approximate to 60% of whom require transfusion. This finding could discourage physicians from using artesunate. We prospectively evaluated a cohort of 123 patients in France who had severe imported malaria that was treated with artesunate; our evaluation focused on outcome, adverse events, and postartesunate delayed-onset hemolysis (PADH). Of the 123 patients, 6 (5%) died. Overall, 97 adverse events occurred. Among the 78 patients who received follow-up for >8 days after treatment initiation, 76 (97%) had anemia, and 21(27%) of the 78 cases were recorded as PADH. The median drop in hemoglobin levels was 1.3 g/dL; 15% of patients with PADH had hemoglobin levels of <7 g/dL, and 1 required transfusion. Despite the high incidence of PADH, the resulting anemia remained mild in 85% of cases. This reassuring result confirms the safety and therapeutic benefit of artesunate.

引用

页码：804 / 812

页数：9

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