title: [Consciousness disorders and severe haemolytic anaemia in a patient coming from overseas].
abstract: A 54-years-old patient coming from Guinea, who presented fever, diarrhoea, consciousness disorders and severe haemolytic anaemia, was admitted to resuscitation unit in France. Despite many explorations carried out (evaluation of traumatic causes, infection, neoplasia, vascular, toxic causes, vitamin deficiency), it was not possible to explain neurological symptomatology. Besides, haemolytic anaemia was due to the ingestion of metamizole in a context of glucose-6-phosphate dehydrogenase deficit. This drug's marketing has been suspended in France since 2006. Despite appropriate treatment, after seven days of hospitalization, the patient died of multi-organ failure and hemophagocytic syndrome. This clinical case illustrates the difficulties encountered to set a diagnosis and manage patients coming from overseas. Uncommon aetiologies for French healthcare professionals should be evoked in the absence of comprehensive clinical information.
authors.affiliation: Ecole du Val de Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France. carinegarcia92@wanadoo.fr
authors.forename: C
authors.initials: C
authors.lastname: Garcia-Hejl
authors.forename: H
authors.initials: H
authors.lastname: Thefenne-Astier
authors.forename: J-C
authors.initials: JC
authors.lastname: Navarrot
authors.forename: E
authors.initials: E
authors.lastname: Batjom
authors.forename: E
authors.initials: E
authors.lastname: Nicand
authors.forename: Y
authors.initials: Y
authors.lastname: Ricordel
authors.forename: J M
authors.initials: JM
authors.lastname: Ramirez
authors.forename: L
authors.initials: L
authors.lastname: Brinquin
mesh_terms: D000743:Anemia, Hemolytic / Q000209:etiology*; D013956:Antithyroid Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D017809:Fatal Outcome; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications / Q000175:diagnosis*; D016701:Guinea / Q000208:ethnology; D006261:Headache / Q000209:etiology; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology; D016778:Malaria, Falciparum / Q000175:diagnosis; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000209:etiology; D008713:Methimazole / Q000009:adverse effects*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010297:Paris; D011595:Psychomotor Agitation / Q000209:etiology*; D012640:Seizures / Q000209:etiology; D014839:Vomiting / Q000209:etiology
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole