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VOLUME 22 , ISSUE 10 ( 2018 ) > List of Articles


Artesunate-induced severe autoimmune hemolytic anemia in complicated malaria

Bhaskar Shahbabu, Ajai Tentu, Anshu Kumar

Keywords : Anemia, artesunate, autoimmune hemolytic anemia, hemolytic, malaria

Citation Information : Shahbabu B, Tentu A, Kumar A. Artesunate-induced severe autoimmune hemolytic anemia in complicated malaria. Indian J Crit Care Med 2018; 22 (10):753-756.

DOI: 10.4103/ijccm.IJCCM_298_18

License: CC BY-ND 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Autoimmune hemolytic anemia (AIHA) is a very rare cause of anemia in a case of malaria and drug-induced AIHA is even rarer. A 50-year old patient with a history of fever for 8 days was diagnosed with a case of complicated malaria with mixed infection having initial parasite index of 45%. He showed good response on initial therapy with artesunate (parasite count reduced to <1%) but his haemoglobin (Hb) continued to drop from 12 g% to 4.9 g% over a course of 11 days. Direct coombs test was positive with reduced haptoglobin and increased lactate dehydrogenase suggesting AIHA. The patient was put on steroids and transfused with saline washed O-negative blood. He gradually recovered over 8 weeks with Hb level rising up to 12 g%. This is a rare case of AIHA following treatment of severe malaria with parenteral artesunate suggesting of the drug immune-related mechanism.

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