Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?

Background: Delayed haemolysis is a frequent adverse event after treatment with artesunate (AS). Removing once-infected pitted erythrocytes by the spleen is the most accepted mechanism of haemolysis in these cases. However, an increasing number of cases with positive direct antiglobulin test (DAT) h...

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Autores: Camprubí D, Pereira A, Rodriguez-Valero N, Almuedo A, Varo R, Casals-Pascual C, Bassat Q, Malvy D, Muñoz J
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p16146
Acesso em linha:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16146
Access Level:acceso abierto
Palavra-chave:Artesunate
PADH
Haemolytic anaemia
Direct antiglobulin test
Corticosteroids
Malaria
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spelling Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?Camprubí DPereira ARodriguez-Valero NAlmuedo AVaro RCasals-Pascual CBassat QMalvy DMuñoz JArtesunatePADHHaemolytic anaemiaDirect antiglobulin testCorticosteroidsMalariaBackground: Delayed haemolysis is a frequent adverse event after treatment with artesunate (AS). Removing once-infected pitted erythrocytes by the spleen is the most accepted mechanism of haemolysis in these cases. However, an increasing number of cases with positive direct antiglobulin test (DAT) haemolysis after AS have been reported. Methods: All malaria cases seen at Hospital Clinic of Barcelona between 2015 and 2017 were retrospectively reviewed. Clinical, parasitological and laboratory data from patients treated with intravenous artesunate-specifically looking for delayed haemolysis and DAT-was collected. Results: Among the 36 severe malaria patients treated with artesunate at the hospital, 10 (27.8%) developed post-artesunate delayed haemolysis. Out of these, DAT was performed in six, being positive in four of them (at least 40%). DAT was positive only for complement-without IgG-suggesting drug-dependent immune-haemolytic anaemia of the immune-complex type. Three of the four patients were treated with corticosteroids and two also received blood transfusion, with a complete recovery. Conclusions: Drug-induced auto-immune phenomena in post-artesunate delayed haemolysis may be underreported and must be considered. The role of corticosteroids should be reassessed.BMC2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16146MALARIA JOURNALISSN: 14752875reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p161462026-05-27T12:37:41Z
dc.title.none.fl_str_mv Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
title Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
spellingShingle Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
Camprubí D
Artesunate
PADH
Haemolytic anaemia
Direct antiglobulin test
Corticosteroids
Malaria
title_short Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
title_full Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
title_fullStr Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
title_full_unstemmed Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
title_sort Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?
dc.creator.none.fl_str_mv Camprubí D
Pereira A
Rodriguez-Valero N
Almuedo A
Varo R
Casals-Pascual C
Bassat Q
Malvy D
Muñoz J
author Camprubí D
author_facet Camprubí D
Pereira A
Rodriguez-Valero N
Almuedo A
Varo R
Casals-Pascual C
Bassat Q
Malvy D
Muñoz J
author_role author
author2 Pereira A
Rodriguez-Valero N
Almuedo A
Varo R
Casals-Pascual C
Bassat Q
Malvy D
Muñoz J
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Artesunate
PADH
Haemolytic anaemia
Direct antiglobulin test
Corticosteroids
Malaria
topic Artesunate
PADH
Haemolytic anaemia
Direct antiglobulin test
Corticosteroids
Malaria
description Background: Delayed haemolysis is a frequent adverse event after treatment with artesunate (AS). Removing once-infected pitted erythrocytes by the spleen is the most accepted mechanism of haemolysis in these cases. However, an increasing number of cases with positive direct antiglobulin test (DAT) haemolysis after AS have been reported. Methods: All malaria cases seen at Hospital Clinic of Barcelona between 2015 and 2017 were retrospectively reviewed. Clinical, parasitological and laboratory data from patients treated with intravenous artesunate-specifically looking for delayed haemolysis and DAT-was collected. Results: Among the 36 severe malaria patients treated with artesunate at the hospital, 10 (27.8%) developed post-artesunate delayed haemolysis. Out of these, DAT was performed in six, being positive in four of them (at least 40%). DAT was positive only for complement-without IgG-suggesting drug-dependent immune-haemolytic anaemia of the immune-complex type. Three of the four patients were treated with corticosteroids and two also received blood transfusion, with a complete recovery. Conclusions: Drug-induced auto-immune phenomena in post-artesunate delayed haemolysis may be underreported and must be considered. The role of corticosteroids should be reassessed.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16146
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16146
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv MALARIA JOURNAL
ISSN: 14752875
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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