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Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis.
Ascoli Bartoli, Tommaso; Lepore, Luciana; D'Abramo, Alessandra; Adamo, Giovanna; Corpolongo, Angela; Scorzolini, Laura; Giancola, Maria Letizia; Bevilacqua, Nazario; Palazzolo, Claudia; Mariano, Andrea; Ippolito, Giuseppe; Buffet, Pierre; Nicastri, Emanuele.
Afiliación
  • Ascoli Bartoli T; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Lepore L; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • D'Abramo A; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy. alessandra.dabramo@inmi.it.
  • Adamo G; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Corpolongo A; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Scorzolini L; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Giancola ML; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Bevilacqua N; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Palazzolo C; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Mariano A; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Ippolito G; Lazzaro Spallanzani, National Institute for Infectious Diseases-IRCCS, Via Portuense, 292, Cap 00149, Rome, Italy.
  • Buffet P; UMRS 1134, Inserm, Université de Paris, 75015, Paris, France.
  • Nicastri E; Laboratory of Excellence GREx, 75015, Paris, France.
Malar J ; 20(1): 206, 2021 Apr 29.
Article en En | MEDLINE | ID: mdl-33926462
BACKGROUND: Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the "pitting" phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT. METHODS: Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use. RESULTS: Twenty-two studies reporting 39 PADH cases were included: median baseline parasitaemia was 20.8% (IQR: 11.2-30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p = 0.01), had a higher baseline parasitaemia (27% vs 17%; p = 0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p = 0.002). Depth and kinetics of delayed anaemia were not associated with DAT positivity. CONCLUSIONS: In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation suggests that DAT result may not be indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but it may be rather a marker of immune activation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 3_ND Problema de salud: 3_malaria / 3_neglected_diseases Asunto principal: Prueba de Coombs / Malaria Vivax / Malaria Falciparum / Artesunato / Hemólisis / Antimaláricos Tipo de estudio: Systematic_reviews Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Malar J Asunto de la revista: MEDICINA TROPICAL Año: 2021 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 3_ND Problema de salud: 3_malaria / 3_neglected_diseases Asunto principal: Prueba de Coombs / Malaria Vivax / Malaria Falciparum / Artesunato / Hemólisis / Antimaláricos Tipo de estudio: Systematic_reviews Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Malar J Asunto de la revista: MEDICINA TROPICAL Año: 2021 Tipo del documento: Article País de afiliación: Italia
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