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静脉用青蒿琥酯治疗重症疟疾导致的严重迟发性溶血继发急性肾损伤。

Acute kidney injury secondary to severe delayed haemolysis in intravenous artesunate use for severe malaria.

机构信息

Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Victorian Infectious Diseases Service, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.

出版信息

BMJ Case Rep. 2021 Jan 26;14(1):e237501. doi: 10.1136/bcr-2020-237501.

DOI:10.1136/bcr-2020-237501
PMID:33500299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7839869/
Abstract

The use of artemisinin derivatives has been recommended by the WHO guidelines in malaria treatment largely due to its rapid parasite clearance and safety profile. This case report details the development of delayed haemolysis and subsequent severe acute kidney injury (AKI) 13 days after commencing intravenous artesunate treatment for malaria in an Australian returned traveller. Delayed haemolysis may be an under-recognised complication following artesunate use and if severe, can be complicated by AKI. Therefore, close patient follow-up following treatment is required to ensure prompt recognition of this phenomenon.

摘要

世卫组织指南在疟疾治疗中推荐使用青蒿素衍生物,主要是因为它能迅速清除寄生虫和具有良好的安全性。本病例报告详细介绍了一名澳大利亚归国旅行者在接受青蒿琥酯静脉治疗疟疾 13 天后发生迟发性溶血和随后发生严重急性肾损伤(AKI)的情况。迟发性溶血可能是青蒿琥酯使用后的一种未被充分认识的并发症,如果严重,可并发 AKI。因此,需要对患者进行密切随访,以确保及时发现这种现象。

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本文引用的文献

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Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure.急性肾损伤后不良结局的长期风险:使用暴露共识定义的队列研究的系统评价和荟萃分析。
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Malar J. 2015 Jun 18;14:246. doi: 10.1186/s12936-015-0760-x.
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Delayed haemolysis after artesunate treatment of severe malaria - review of the literature and perspective.青蒿琥酯治疗重症疟疾后的迟发性溶血——文献复习及展望。
Travel Med Infect Dis. 2015 Mar-Apr;13(2):143-9. doi: 10.1016/j.tmaid.2015.03.003. Epub 2015 Mar 10.
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Haemolysis associated with the treatment of malaria with artemisinin derivatives: a systematic review of current evidence.青蒿素衍生物治疗疟疾相关的溶血反应:当前证据的系统评价
Int J Infect Dis. 2014 Dec;29:268-73. doi: 10.1016/j.ijid.2014.09.007. Epub 2014 Nov 1.
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