Leucopenia and abnormal liver function in travellers on malaria chemoprophylaxis.
Of 2887 travellers between the years 1984-1985, 451 on prophylactic antimalarials were studied retrospectively for adverse haematological or hepatic drug reactions and compared to 296 drug non-users. Travellers using amodiaquine, chloroquine, or pyrimethamine for less than 10 weeks had significantly lower total leucocyte counts than non-users. This was due to diminution of lymphocytes, not neutrophils. Travellers using amodiaquine for less than 10 weeks also had significantly higher serum aspartate aminotransferase (SGPT) levels than non-users. Amodiaquine was associated with a 3.1-times increased risk (95% confidence limits 1.8-5.4) of abnormal SGPT values. We consider toxic products, including metabolites of amodiaquine, the most likely cause of amodiaquine-related hepatotoxicity in travellers.
Stürchler
D
D
Medical Department, Swiss Tropical Institute, Basel, Switzerland.
Schär
M
M
Gyr
N
N
D000293:Adolescent; D000328:Adult; D000655:Amodiaquine / Q000009:adverse effects; D000962:Antimalarials / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000009:adverse effects; D004906:Erythrocyte Count / Q000187:drug effects; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D007970:Leukopenia / Q000139:chemically induced* / Q000453:epidemiology; D008111:Liver Function Tests; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011739:Pyrimethamine / Q000009:adverse effects; D013557:Switzerland; D014195:Travel
D000962:Antimalarials; D000655:Amodiaquine; D002738:Chloroquine; D011739:Pyrimethamine