Automated erythrocytapheresis in severe falciparum malaria: A critical appraisal.
Imported falciparum malaria is increasing in Western countries. In patients with severe disease, exchange transfusion has been added to antimalarial and conventional supportive therapy to increase removal of parasitized erythrocytes, but hemodynamic compromise limits its use; automated erythrocytapheresis may be advantageous. We review published reports of patients with severe falciparum malaria treated by automated erythrocytapheresis combined with standard therapy and add three more cases to the literature. No studies have been conducted to evaluate its clinical efficacy, and this adjunct therapy should therefore be considered as salvage therapy. Apheresis of red cells appears feasible, safe and effective in rapidly reducing parasite count.
Nieuwenhuis
Jellie A
JA
Intensive and Respiratory Care Unit, Department of Internal Medicine, Groningen University Medical Centre, University of Groningen, The Netherlands.
Meertens
John H J M
JH
Zijlstra
Jan G
JG
Ligtenberg
Jack J M
JJ
Tulleken
Jaap E
JE
van der Werf
Tjip S
TS
D004912:Erythrocytes; D005078:Exchange Transfusion, Whole Blood; D006801:Humans; D016778:Malaria, Falciparum / Q000628:therapy*