Red cell exchange, erythrocytapheresis, in the treatment of malaria with high parasitaemia in returning travellers
In severe falciparum malaria with high parasitaemia, removal of parasitized erythrocytes is generally considered to be of value as adjunctive therapy in addition to standard chemotherapy. Such removal is commonly achieved by exchange transfusion but this procedure is time-consuming and may be associ...
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| Veröffentlicht in: | Transactions of the Royal Society of Tropical Medicine and Hygiene 2000-07, Vol.94 (4), p.353-356 |
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| container_title | Transactions of the Royal Society of Tropical Medicine and Hygiene |
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| creator | MACALLAN, D. C POCOCK, M ROBINSON, G. T PARKER-WILLIAMS, J BEVAN, D. H |
| description | In severe falciparum malaria with high parasitaemia, removal of parasitized erythrocytes is generally considered to be of value as adjunctive therapy in addition to standard chemotherapy. Such removal is commonly achieved by exchange transfusion but this procedure is time-consuming and may be associated with haemodynamic disturbance. Current-generation automated cell-separator hardware and software allows prompt red cell exchange, erythrocytapheresis, in a single continuous-flow isovolaemic procedure. We describe the application of this procedure to 5 cases of severe falciparum malaria in travellers returning to the UK from the tropics. All patients also received quinine and conventional supportive therapy. In all cases, dramatic reduction in parasitaemia was achieved within 2 h with subsequent complete clinical recovery. Erythrocytapheresis has significant advantages over exchange transfusion in terms of speed, efficiency, haemodynamic stability and retention of plasma components such as clotting factors and may thus represent an improvement in adjunctive therapy for severe malaria. |
| doi_str_mv | 10.1016/s0035-9203(00)90101-9 |
| format | Article |
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In all cases, dramatic reduction in parasitaemia was achieved within 2 h with subsequent complete clinical recovery. 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We describe the application of this procedure to 5 cases of severe falciparum malaria in travellers returning to the UK from the tropics. All patients also received quinine and conventional supportive therapy. In all cases, dramatic reduction in parasitaemia was achieved within 2 h with subsequent complete clinical recovery. Erythrocytapheresis has significant advantages over exchange transfusion in terms of speed, efficiency, haemodynamic stability and retention of plasma components such as clotting factors and may thus represent an improvement in adjunctive therapy for severe malaria.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cytapheresis - methods</subject><subject>Erythrocyte Transfusion - methods</subject><subject>Female</subject><subject>Human protozoal diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Malaria</subject><subject>Malaria, Falciparum - therapy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parasitemia - therapy</subject><subject>Parasitic diseases</subject><subject>Protozoal diseases</subject><subject>Travel</subject><subject>Treatment Outcome</subject><subject>Tropical medicine</subject><issn>0035-9203</issn><issn>1878-3503</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0NtKxDAQBuAgirseHkHJhYjCVnNo2vRSFk-wIIhelzGdbCM9rEmq7ttbcdWrgZ9vZpgh5IizC854dhkYkyopBJNnjJ0XbAyTYotMuc51IhWT22T6RyZkL4RXxoTiqtglE865yIXkU-IfsaIGm4bip6mhW-KMol_H2vdmHWFVo8fgwoy6jsYaafQIscUu0t7SFhrwDuiHizWt3bKmK_AQXARsx3hs8RgH37luOTbC-7gGfTggOxaagIebuk-eb66f5nfJ4uH2fn61SIzQOia5xSJHFDZTWmjL00wUWaq5sDpDaVQOlnMlM6y0REwRDAq0WqhKGCPAyH1y-jN35fu3AUMsWxe-T4UO-yGUuUi1yHk2wuMNHF5arMqVdy34dfn7pRGcbAAEA4310BkX_l1aqFwK-QUZW3lg</recordid><startdate>20000701</startdate><enddate>20000701</enddate><creator>MACALLAN, D. 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| ispartof | Transactions of the Royal Society of Tropical Medicine and Hygiene, 2000-07, Vol.94 (4), p.353-356 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adolescent Adult Biological and medical sciences Cytapheresis - methods Erythrocyte Transfusion - methods Female Human protozoal diseases Humans Infectious diseases Malaria Malaria, Falciparum - therapy Medical sciences Middle Aged Parasitemia - therapy Parasitic diseases Protozoal diseases Travel Treatment Outcome Tropical medicine |
| title | Red cell exchange, erythrocytapheresis, in the treatment of malaria with high parasitaemia in returning travellers |
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