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 antig...

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Autores: Camprubí Ferrer, Daniel, Pereira Saavedra, Arturo, Rodriguez Valero, Natalia, Almuedo Riera, Alex, Varo, Rosauro, Casals Pascual, Climent, Bassat Orellana, Quique, Malvy, Denis, Muñoz Gutiérrez, José
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/182466
Acesso em linha:https://hdl.handle.net/2445/182466
Access Level:acceso abierto
Palavra-chave:Malària
Anèmia hemolítica
Malaria
Hemolytic anemia
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spelling Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?Camprubí Ferrer, DanielPereira Saavedra, ArturoRodriguez Valero, NataliaAlmuedo Riera, AlexVaro, RosauroCasals Pascual, ClimentBassat Orellana, QuiqueMalvy, DenisMuñoz Gutiérrez, JoséMalàriaAnèmia hemolíticaMalariaHemolytic anemiaBACKGROUND: 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.BioMed Central2022202220192022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion7 p.application/pdfhttps://hdl.handle.net/2445/182466Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/s12936-019-2762-6Malaria Journal, 2019, vol. 18, num. 123https://doi.org/10.1186/s12936-019-2762-6cc-by (c) Camprubí, Daniel et al., 2019https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1824662026-05-29T05:05:01Z
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 Ferrer, Daniel
Malària
Anèmia hemolítica
Malaria
Hemolytic anemia
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 Ferrer, Daniel
Pereira Saavedra, Arturo
Rodriguez Valero, Natalia
Almuedo Riera, Alex
Varo, Rosauro
Casals Pascual, Climent
Bassat Orellana, Quique
Malvy, Denis
Muñoz Gutiérrez, José
author Camprubí Ferrer, Daniel
author_facet Camprubí Ferrer, Daniel
Pereira Saavedra, Arturo
Rodriguez Valero, Natalia
Almuedo Riera, Alex
Varo, Rosauro
Casals Pascual, Climent
Bassat Orellana, Quique
Malvy, Denis
Muñoz Gutiérrez, José
author_role author
author2 Pereira Saavedra, Arturo
Rodriguez Valero, Natalia
Almuedo Riera, Alex
Varo, Rosauro
Casals Pascual, Climent
Bassat Orellana, Quique
Malvy, Denis
Muñoz Gutiérrez, José
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malària
Anèmia hemolítica
Malaria
Hemolytic anemia
topic Malària
Anèmia hemolítica
Malaria
Hemolytic anemia
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
2022
2022
2022
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://hdl.handle.net/2445/182466
url https://hdl.handle.net/2445/182466
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s12936-019-2762-6
Malaria Journal, 2019, vol. 18, num. 123
https://doi.org/10.1186/s12936-019-2762-6
dc.rights.none.fl_str_mv cc-by (c) Camprubí, Daniel et al., 2019
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Camprubí, Daniel et al., 2019
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 7 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,228081

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