Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria.

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    • Subject Terms:
      HEMOLYSIS & hemolysins; ARTEMISININ; ANTIMALARIALS; ANTIGEN-antibody reactions; IMMUNITY; HEMOGLOBINS; DRUG therapy for malaria; ANEMIA; COMBINATION drug therapy; COMPARATIVE studies; ETHANOLAMINES; HYDROCARBONS; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; ORAL drug administration; QUINOLINE; RESEARCH; EVALUATION research; THERAPEUTICS
    • Abstract:
      Episodes of delayed hemolysis 2-6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3-2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR -0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia. [ABSTRACT FROM AUTHOR]
    • Abstract:
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