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Haemolytic anaemia?: case report A 22-year-old woman developed haemolytic anaemia following administration of artemether/lumefantrine [dosage not stated] and artesunate. The woman received oral artemether/lumefantrine for malaria. The following day, she developed jaundice and parasitaemia increased, so she received IV artesunate 2.4 mg/kg every 12 hours. Her parasitaemia decreased to 0.01% after 24 hours. After 36 hours of artesunate, treatment was switched back to oral artemether/ lumefantrine. On day 8, she developed a febrile peak and conjunctival jaundice, and tests revealed signs of haemolytic anaemia, including an LDH flare and decrease in haemoglobin. No parasites were detected on blood smear. On day 14, the woman received a blood transfusion. Over the following days her condition improved, and she was discharged on day 18. On day 40, she was asymptomatic, and biochemical and haematological parameters were within the normal range. Author comment: A "possibility is haemolysis due to lumefantrine. . . Since unexplained haemolysis has been repeatedly observed, specific surveillance in artesunatetreated patients is required". Caramello P, et al. Severe malaria, artesunate and haemolysis. Journal of Antimicrobial Chemotherapy 67: 2053-2054, No. 8, Aug 2012. Available from: 803078063 URL: http://dx.doi.org/10.1093/jac/dks139 - Italy

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Reactions 6 Oct 2012 No. 1422