Post-Artesunate Delayed Hemolysis: A Review of Current Evidence
2
Issued Date
2023-01-01
Resource Type
eISSN
24146366
Scopus ID
2-s2.0-85146794798
Journal Title
Tropical Medicine and Infectious Disease
Volume
8
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Tropical Medicine and Infectious Disease Vol.8 No.1 (2023)
Suggested Citation
Jaita S., Madsalae K., Charoensakulchai S., Hanboonkunapakarn B., Chotivanit K., McCarthy A.E., Matsee W. Post-Artesunate Delayed Hemolysis: A Review of Current Evidence. Tropical Medicine and Infectious Disease Vol.8 No.1 (2023). doi:10.3390/tropicalmed8010049 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82596
Title
Post-Artesunate Delayed Hemolysis: A Review of Current Evidence
Other Contributor(s)
Abstract
Artesunate is the drug of choice for treating patients with severe malaria. Post-artesunate delayed hemolysis (PADH) is an uncommon adverse event from malaria treatment. Most patients with PADH are non-immune travelers. The pathophysiology of PADH is not fully understood, but the most likely mechanism is “pitting”, in which red blood cells carrying dead parasites killed by artesunate’s action are directed to the spleen for clearing the dead parasites. After the cleansing process, these red blood cells re-enter the circulation but with a smaller size and impaired integrity, resulting in a shortened lifespan of 7–21 days. Therefore, most patients with PADH usually present with clinical features of hemolytic anemia 7 days or later after the initiation of artesunate. To date, the benefits of artesunate treatment outweigh its adverse events, and no fatal cases have resulted from PADH. However, the hematological follow-up of patients with malaria treated with artesunate is recommended for clinicians to detect any delayed hemolytic event early and prevent potentially serious consequences.