title: Haemoglobinuria in a 38-year-old French expatriate man living in Cameroon following artemisinin-based antimalarial treatment.
abstract: Massive haemoglobinuria is encountered rarely during the course of malaria. It is usually considered a diagnostic criterion for severe malaria, together with anaemia, acute renal failure and jaundice. Haemoglobinuria can also present among expatriates travelling to endemic areas following repeated exposure to quinoline or arylaminoalcohol drugs. A case is described of haemoglobinuria developing in a 38-year-old French expatriate diagnosed concurrently with numerous tropical infections, and treated on presumptive basis with an antimalarial regimen containing artemisinin derivatives. Haemoglobinuria resolved spontaneously within a few days. Although this case does not definitely indicate a causal link between haemoglobinuria and artemisinin derivatives, the risk of such infrequent side-effects should be taken into account in pharmacovigilance monitoring. Moreover, the patient illustrates the multifaceted pathology that can be encountered with tropical infections.
authors.affiliation: Travel Clinics and Tropical Disease Unit, Department of Internal Medicine, Infectious Diseases and Tropical Medicine, University Hospital Center, Bordeaux, France. kezzedin@ulb.ac.be
authors.forename: Khaled
authors.initials: K
authors.lastname: Ezzedine
authors.forename: Thierry
authors.initials: T
authors.lastname: Pistone
authors.forename: Marie-Catherine
authors.initials: MC
authors.lastname: Receveur
authors.forename: Thomas
authors.initials: T
authors.lastname: Cressend
authors.forename: Céline
authors.initials: C
authors.lastname: Diéval
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000009:adverse effects*; D037621:Artemisinins / Q000009:adverse effects*; D002163:Cameroon; D003937:Diagnosis, Differential; D005602:France; D006456:Hemoglobinuria / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D014195:Travel
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin