%0 Case Reports
%T Fatal case of delayed-onset haemolytic anaemia after oral artemether-lumefantrine.
%A Gustafsson L
%A James S
%A Zhang Y
%A Thozhuthumparambil KP
%J BMJ Case Rep
%V 14
%N 11
%D Nov 2021 19
%M 34799392
暂无%R 10.1136/bcr-2021-245718
%X Artemisinin derivatives are used globally in the management of falciparum malaria. Postartemisinin delayed haemolysis (PADH) is a recognised adverse event contributing to severe anaemia. To the best of our knowledge, we report the first recorded fatal case of PADH. A 60-year-old woman presented with two episodes of collapse at home and feeling generally unwell. She had recently been treated for uncomplicated falciparum malaria 1 month prior with artemether 80 mg/lumefantrine 480 mg in Congo. Her results on admission revealed an anaemia (haemoglobin 43 g/L), raised lactate dehydrogenase and positive direct antiglobulin test that suggested an intravascular haemolytic process. She made a capacitous decision to refuse blood products in line with her personal beliefs. Despite best supportive treatment, she did not survive. This case highlights the importance of postartemisinin follow-up and should encourage discussion and careful consideration of its use in the context of lack of access to/patient refusal of blood products.