Table 6 Haemolysis in 7 hospitalized malaria patients receiving IV artesunate treatment
Patient (gender, age) | Severe malaria criteria | Anti-malarial treatment | PCT (days)* | Hb nadir(days)* | Additional diagnostics | Treatment for haemolysis |
|---|---|---|---|---|---|---|
Late onset hemolysis | ||||||
1 (♂, 53y) | Hyperparasitaemia (34%), impaired consciousness, jaundice | Q AS (2 doses) AP AET | 4 | 4.3 (D20) | Coombs: C3d+ | None |
4 (♀, 50y) | Hyperparasitaemia (19%), impaired consciousness, jaundice, acidosis, hyperlactaemia, renal impairment | AS (4 doses) AP MET | 3 | 4.4 (D30) | Multiple in the context of an unexplained neurological disorder‡; coombs not performed | None |
38 (♀, 50y) | Hyperparasitaemia(11%), jaundice | AS (4 doses) AP | 3 | 2.8 (D13) | Coombs: neg; G6PD deficient (heterozygous); Shigellaflexneri dysentery | Transfusion(4 PC) |
55 (♀, 44y) | Hyperparasitaemia (37%) | Q AS (3 doses) AL | 4 | 3.8 (D15) | Coombs: IgG +, C3d+ | Transfusion(2 × 3 PC) Steroids |
58 (♂, 5y) | Hyperparasitaemia (12%), impaired consciousness, shock | Q AS (doses) AL | 4(FCT 10 d) | 3.8 (D8) | Coombs: neg; hemoculture - | None |
59 (♀, 50y) | Hyperparasitaemia (30%), hemoglobinuria, jaundice | AS (doses) AL | 10 (FCT 17 d) | 4.3 (D13) | Coombs: IgG+, IgM+, hemoculture - G6PD: normal | Transfusion (2 PC) Steroids |
Persistent hemolysis | ||||||
28 (♂, 71y) | Hyperparasitaemia (20%), impaired consciousness, respiratory distress, acidosis, hypoglycaemia, hyperlactaemia, renal impairment | Q AS (doses) AL AET | 7†| 3.7 (D13) | Coombs: neg | Transfusion (7 times, total of 24 PC) |