Team Haem saves Christmas: The Summary

Jingle bells, jingle bells

Jingle all the way

Oh what fun it is to tweet TeamHaem’s case today!

 

The haemolysis is self-limiting

No more parasites are seen

The pitted red cells that have lost malaria

Are being chomped up in the spleen

 

Jingle bells, jingle bells

Jingle all the way

Oh what fun it is to tweet TeamHaem’s case today!

 

The DAT is clearly negative

Steroids were not given today

Jingle can go back to work

All elves shout hooray!

 

Jingle bells, jingle bells

Jingle all the way

Oh what fun it is to tweet TeamHaem’s case today!

 

SUMMARY

With a parasite count of >5%, poor Jingle had severe malaria

As per NICE and WHO recommendations, IV artesunate was started.  This cleared the parasites quickly.

Delayed haemolysis is a recognised complication of IV artesunate therapy.  There is no clear evidence to guide management and all data comes from case reports/series.  Some clinicians have given steroids, and a proportion do seem to be autoimmune, although it is likely to be self-limiting.

It appears that most of the haemolysis is due to the destruction of red cells that become pitted following death of the parasites.

Further reading:

Lalloo, D.G., Shingadia, D., Bell, D.J., Beeching, N.J., Whitty, C.J. and Chiodini, P.L., 2016. UK malaria treatment guidelines 2016. Journal of Infection72(6), pp.635-649.

https://cks.nice.org.uk/malaria#!topicSummary

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Uncategorised. Bookmark the permalink.