Severe Plasmodium vivax cerebral malaria complicated by hemophagocytic lymphohistiocytosis treated with artesunate and doxycycline

Amireh, Sawsan; Shaaban, Hamid; Guron, Gunwant

doi:10.1016/j.hemonc.2016.06.001

Cited by 10 publications

(9 citation statements)

References 14 publications

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“…In some African hospitals, oral doxycycline is used systematically in combination with intravenous artesunate in the treatment of severe P. falciparum malaria [ 17 ]. Additionally, some severe P. vivax cerebral malaria cases have been treated with artesunate and doxycycline [ 18 , 19 ]. However, doxycycline is contraindicated in children under 8 years of age because of the risk of yellow tooth discolouration and dental enamel hypoplasia.…”

Section: Introductionmentioning

confidence: 99%

The end of a dogma: the safety of doxycycline use in young children for malaria treatment

Gaillard

Briolant

Madamet

et al. 2017

Malar J

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Anti-malarial drug resistance to chloroquine and sulfadoxine–pyrimethamine has spread from Southeast Asia to Africa. Furthermore, the recent emergence of resistance to artemisinin-based combination therapy (ACT) in Southeast Asia highlights the need to identify new anti-malarial drugs. Doxycycline is recommended for malaria chemoprophylaxis for travel in endemic areas, or in combination with the use of quinine for malaria treatment when ACT is unavailable or when the treatment of severe malaria with artesunate fails. However, doxycycline is not used in young children under 8 years of age due to its contraindication due to the risk of yellow tooth discolouration and dental enamel hypoplasia. Doxycycline was developed after tetracycline and was labelled with the same side-effects as the earlier tetracyclines. However, recent studies report little or no effects of doxycycline on tooth staining or dental enamel hypoplasia in children under 8 years of age. In the United States, the Centers for Disease Control and Prevention have recommended the use of doxycycline for the treatment of acute and chronic Q fever and tick-borne rickettsial diseases in young children. It is time to rehabilitate doxycycline and to recommend it for malaria treatment in children under 8 years of age.

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Section: Introductionmentioning

confidence: 99%

The end of a dogma: the safety of doxycycline use in young children for malaria treatment

Gaillard

Briolant

Madamet

et al. 2017

Malar J

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“…vivax [8] [13], with P. falciparum accounting for most of these cases. The pathogenesis is not yet clear but may be related to immune dysfunction caused by falciparum malaria.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Malaria-associated Secondary Hemophagocytic Lymphohistiocytosis and a Review of the Literature

Zhou

Duan²

2020

Preprint

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Background: Malaria-associated secondary hemophagocytic lymphohistiocytosis (HLH) is rare. Moreover, the literature on malaria-associated HLH is sparse, and there are no similar cases reported in China.Case presentation: We report a case of a 29-year-old young woman with unexplained intermittent fever who was admitted to our hospital due to an unclear diagnosis. The patient concealed her history of travel to Nigeria and Dubai before onset. We made a diagnosis of malaria-associated secondary HLH. The treatment strategy for the patient included treatment of the inciting factor (artemether for 9 days followed by artemisinin for 5 days), the use of immunosuppressants (steroids, intravenous immunoglobulin) and supportive care. The patient was discharged in normal physical condition after 25 days of intensive care. No relapses were documented on follow-up at six months and 1 year. Conclusion: Early diagnosis of the primary disease along with timely intervention and a multidisciplinary approach can help patients achieve a satisfactory outcome.

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“…All those lead to hemophagocytosis in the bone marrow and the reticulo-endothelial system, which explain clinical and biological symptoms, such as cytopenia or splenomegaly. High levels of interferon γ, interleukin-1 and interleukin-6 play a role in the syndrome, explaining fever or hypertriglyceridemia, for example (4,5,10). Two types of HLH were identified: Familial HLH, related to perforin gene mutation, usually noted in infancy or early childhood, representing therefore, 80 % of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…Infection-associated HLH (I-HLH), noted with both adults and children (3), is most commonly secondary to viral infections such as Epstein-Barr virus, which is the most responsible for severe form of I-HLH (4). Less commonly, I-HLH is triggered by other herpes viruses such as Herpes simplex virus, Varicella-zoster virus and Cytomegalovirus (5). Bacterial, fungal and parasitic infections were associated with I-HLH (3).…”

Section: Introductionmentioning

confidence: 99%

Hemophagocytic lymphohistiocytosis secondary to infectious diseases

et al. 2019

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Introduction: Secondary hemophagocytic lymphohistiocytosis (HLH) occurs in association with infections, autoimmune disorder or malignancy. Only few studies reported cases of infection-associated HLH (I-HLH). We aimed to study the clinical, laboratory and therapeutic features of I-HLH among children and adults. Material and methods: We conducted a retrospective study including all patients hospitalized in Pediatric and infectious diseases department with confirmed diagnosis of I-HLH between 2011 and 2017. Results: We enrolled 19 cases with I-HLH, among whom 11 cases were males (57.8%). We identified 15 children and 4 adults. The median age was 11 years [1-65 years]. Physical examination showed splenomegaly in 15 cases (78.9%) and hepatomegaly in 10 cases (52.6%). Regarding laboratory examinations, anemia and elevated ferritin levels were noted in all cases. Bone marrow aspiration showed images of haemophagocytosis in all cases. Bacterial infection was noted in 10 cases (52.6%) and parasitic infection in 5 cases (26.3%). All patients received symptomatic and/or etiological treatment. Specific treatment with corticosteroids and human immunoglobulins were used in 7 cases (36.8%). Ten patients were dead (52.6%) due to multiple organ failure. Conclusions: Hemophagocytic lymphohistiocytosis was a life-threatening disease. The prognosis depends on the underlying etiology, but remains poor. Prompt diagnosis and treatment are crucial in order to improve the outcome.

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Severe Plasmodium vivax cerebral malaria complicated by hemophagocytic lymphohistiocytosis treated with artesunate and doxycycline

Cited by 10 publications

References 14 publications

The end of a dogma: the safety of doxycycline use in young children for malaria treatment

The end of a dogma: the safety of doxycycline use in young children for malaria treatment

A Case Report of Malaria-associated Secondary Hemophagocytic Lymphohistiocytosis and a Review of the Literature

Hemophagocytic lymphohistiocytosis secondary to infectious diseases

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