Pathology QueenslandDepartments of Haematology and Oncology Department of Intensive Care Medicine, Townsville Hospital, Townsville, Queensland, Australia.
Intern Med J. 2011 Jan;41(1a):60-3. doi: 10.1111/j.1445-5994.2010.02362.x.
We describe a case of severe falciparum malaria with hyperparasitaemia. Treatment with automated erythrocytapheresis, in conjunction with parenteral artesunate, produced a rapid and sustained fall in parasite burden. Several poor prognostic features were present at admission. Despite the development of a severe headache with abnormal cerebrospinal fluid parameters and transient pulmonary oedema, a complete recovery was observed. Erythrocytapheresis can be considered in selected cases where facilities exist and has theoretical and practical advantages over traditional methods of red cell exchange transfusion. The paucity of systematic or trial evidence convincingly demonstrating a benefit in terms of morbidity or mortality has limited its application. However, the lack of robust trial data should not in itself invalidate considering this therapeutic option in the appropriate context.
我们描述了一例严重的恶性疟原虫疟疾伴血液寄生虫增多症。采用自动化红细胞分离术联合青蒿琥酯静脉注射治疗，寄生虫载量迅速且持续下降。入院时存在多个不良预后特征。尽管出现严重头痛、脑脊液参数异常和短暂性肺水肿，但观察到完全恢复。在有条件的情况下，可以考虑使用红细胞分离术，与传统的红细胞置换输血方法相比，它具有理论和实践上的优势。缺乏系统或试验证据令人信服地证明在发病率或死亡率方面的获益，限制了其应用。然而，缺乏稳健的试验数据本身不应否定在适当情况下考虑这种治疗选择。
