Haemoglobinuria in a 38-year-old French expatriate man living in Cameroon following artemisinin-based antimalarial treatment.
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.
Ezzedine
Khaled
K
Travel Clinics and Tropical Disease Unit, Department of Internal Medicine, Infectious Diseases and Tropical Medicine, University Hospital Center, Bordeaux, France. kezzedin@ulb.ac.be
Pistone
Thierry
T
Receveur
Marie-Catherine
MC
Cressend
Thomas
T
Diéval
Céline
C
Malvy
Denis
D
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
D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin