Autoimmune hemolytic anemia and autoantibodies in a patient with Plasmodium falciparum infection: report of a rare case and review of the literature

Figures & Tables

Reference/	Present	[2]	[3]	[4]			[7]
Characteristic	case (2016)
Age (years)	42	27	17	15	7	15	7
Sex	Female	Male	Female	Female	Female	Female	Male
Presenting symptom	Fever	Fever	Fever	Fever	Fever	Fever	Fever
	(7 days)	(2 days)	(7 days)	(4 days)	(7 days)	(14 days)	(3 days)
Malaria infection	P.f	P.f	P.f	P.v. + P.f	P.v. + P.f	P.f	P.v
Anti-malarial	Artesunate	Antimalarial	Artemether/lumefantrine	Artesunate i.v	Artesunate	Artesunate i.v	Chloroquine
regimen (duration)	i.v. (7 days)	treatment	(6 days) and then artesunate	(5 days)	i.v. (5 days) +	(N/A)	(2 days) + primaquine
		(unknown)	(2 days)		mefloquine		(14 days)
Other antibiotic	Ceftriaxone	N/A	Ceftriaxone, metronidazole	Ceftriaxone	Ceftriaxone	Ceftriaxone	NEG
treatment			gentamicin, piperacillin	doxycycline
			ciprofloxacin
Onset of AIHA (days	12th	1st	14th	9th	7th	11th	2nd
after antimalarial
treatment)
Diagnostic method
Hemoglobin	3.5	Hct. 15.2%	4.6	4.8	5.1	4.5	5.2
(g/dL)
Coombs test	POS	NEG	POS	NEG	N/A	NEG	POS
LDH (U/L)	High	N/A	High	High	High	High	N/A
Identify cause
ANA	NEG	N/A	NEG	NEG	POS	NEG	N/A
		CA test POS		CA test POS
Antibody	Autoanti-E	N/A	N/A	N/A	N/A	N/A	Autoanti-I
identification	Autoanti-I
Specific treatment	Predni	No	Methylprednisolone	Prednisolone	Prednisolone	Prednisolone	Prednisolone
for AIHA (dosage)	solone		(60 mg/day × 7 days)	(1 MKD)	(N/A)	(0.5 MKD)	(1 MKD)
	(1 MKD)		Prednisolone (1 MKD)
PRC transfusion	1	0	0	2	3	0	1
(unit)
Duration of recovery
Malaria infection	5	N/A	N/A	N/A	7	11	2
(days)
AIHA, anemia (days)	8	4	7	28	28	56	10
Stop prednisolone	30	N/A	60	42	28	N/A	56
(days)