[Haemolytic crisis of blackwater fever following artemether-lumefantrine intake].
A second haemolytic crisis of blackwater fever (BWF) following a combination of artemether-lumefantrine intake, in an 8-year-old Congolese boy is reported. The patient had a history of BWF after quinine intake. He was given artemether-lumefantrine treatment for malaria. He was free from G6PD deficiency and abnormal haemoglobin. Sepsis was eliminated. Haemolysis was noted with 5.6 g/dl of haemoglobin, negative direct antiglobulin test, and LDH at 893 IU/l. Low-level Plasmodium falciparum was found. The outcome was favourable with rehydration. BWF has been described with quinine, mefloquine and halofantrine. Several case reports have been published of haemolysis after lumefantrine, but it is quite rare. This case has a major therapeutic implication: aryl-amino-alcohol should be strictly contraindicated in patients with history of BWF with aryl-amino-alcohols intake.
Aloni
N M
NM
Unité de Néphrologie Pédiatrique, Département de Pédiatrie, Cliniques Universitaires de Kinshasa, BP 123, Kinshasa-XI, République Démocratique du Congo. nephropedcuk@yahoo.fr
Nsangu
M
M
Kunuanunua
T
T
Kadima
T B
TB
Muanda
T F
TF
D000962:Antimalarials / Q000009:adverse effects*; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000009:adverse effects*; D001742:Blackwater Fever / Q000139:chemically induced*; D002648:Child; D004338:Drug Combinations; D004983:Ethanolamines / Q000009:adverse effects*; D005449:Fluorenes / Q000009:adverse effects*; D006801:Humans; D008297:Male
D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes