Delayed haemolysis after artesunate therapy in a cohort of patients with severe imported malaria due to Plasmodium falciparum.

INTRODUCTION: Delayed haemolytic anaemia is one of the more frequent events after treatment with intravenous artesunate in patients with severe malaria. Little is known about its frequency and the outcomes of patients with this condition. METHODS: A retrospective study was conducted to describe the incidence of delayed haemolysis in a cohort of patients with severe malaria by Plasmodium falciparum treated with artesunate between August 2013 and July 2015. RESULTS: The study included 52 patients with malaria due to Plasmodium falciparum, with 21 having severe malaria. The majority were male (66.7%), and the median age was 43 years. Four patients (19%) presented post-artesunate delayed haemolysis 11-13 days from the initiation of treatment. Two patients required hospital admission and red blood cell transfusion. CONCLUSION: Post-artesunate delayed haemolysis is frequent in patients with severe malaria treated with intravenous artemisinins. These patients should be monitored for 4 weeks after treatment is started.

Delayed haemolysis after artesunate therapy in a cohort of patients with severe imported malaria due to Plasmodium falciparum / Hemólisis diferida tras el tratamiento con artesunato en una cohorte de pacientes con malaria grave importada por Plasmodium falciparum

Introduction: Delayed haemolytic anaemia is one of the more frequent events after treatment with intravenous artesunate in patients with severe malaria. Little is known about its frequency and the outcomes of patients with this condition. Methods: A retrospective study was conducted to describe the incidence of delayed haemolysis in a cohort of patients with severe malaria by Plasmodium falciparum treated with artesunate between August 2013 and July 2015. Results: The study included 52 patients with malaria due to Plasmodium falciparum, with 21 having severe malaria. The majority were male (66.7%), and the median age was 43 years. Four patients (19%) presented post-artesunate delayed haemolysis 11-13 days from the initiation of treatment. Two patients required hospital admission and red blood cell transfusion. Conclusion: Post-artesunate delayed haemolysis is frequent in patients with severe malaria treated with intravenous artemisinins. These patients should be monitored for 4 weeks after treatment is started (AU)

Introducción: La anemia hemolítica diferida es uno de los acontecimientos más frecuentes tras el tratamiento con artesunato intravenoso en pacientes con malaria grave. Se desconocen con exactitud la frecuencia y evolución de los pacientes que la presentan. Métodos: Estudio retrospectivo sobre la incidencia de hemólisis diferida en una cohorte de pacientes con malaria grave por Plasmodium falciparum tratados con artesunato intravenoso entre agosto de 2013 y julio de 2015. Resultados: De 52 pacientes con malaria por Plasmodium falciparum, 21 cumplían criterios de gravedad. La mayoría eran hombres (66,7%) y la mediana de edad era de 43 años. Cuatro pacientes (19%) presentaron hemólisis diferida post-artesunato, de 11 a 13 días tras el inicio del tratamiento. Dos pacientes requirieron hospitalización y transfusión de hematíes. Conclusión: La hemólisis diferida post-artesunato es frecuente en los pacientes con malaria grave tratados con artesunato intravenoso. Estos pacientes deben ser monitorizados al menos 4 semanas tras el tratamiento (AU)