Management of a Case of Chloroquine-Resistant Falciparum Malaria in aPregnant Woman With Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency
-The available antimalarial drugs for the treatment of Plasmodium falciparum malaria during pregnancy are potentially toxic, expecially in the presence of red blood cells (RBC) defects. We describe a case of chloroquine-resistant malaria by P. falciparum in a pregnant woman with glucose-6-phosphate dehydrogenase (G6PD) deficiency successfully treated with pyrimethamine followed by mefloquine administration. The susceptibility of P. falciparum to chloroquine and mefloquine was assessed by an in vitro test before treatment. Pyrimethamine and mefloquine were administered at the 18th and 22nd week of pregnancy, respectively. Mefloquine concentrations were monitored in the mother's blood at 2, 4, 8, 12, 24 and 48 hr after the administration to define effective blood-drug concentrations. Blood smear examination was negative after 48 hr post mefloquine treatment. No hystologic lesions of the placenta were observed. The newborn presented normal clinical parameters. The administration of pyrimethamine prevented massive placental infection, thus permitting the fetus to achieve suitable gestational age for further treatment with mefloquine to eradicate P. falciparum malaria without deleterious effects to the newborn. Subsequent studies could contribute to define safe administration of mefloquine in G6PD-deficient pregnant woman..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
1999 |
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| Erschienen: |
Stuttgart: Georg Thieme Verlag ; 1999 |
| Reproduktion: |
Thieme Zeitschriftenarchive 1980-2007 |
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| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
| Enthalten in: |
American journal of perinatology - 16(1999), 08 vom: Aug., Seite 435-440 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cultrera, Rosario [VerfasserIn] |
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| Links: |
dx.doi.org [Deutschlandweit zugänglich] |
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| Themen: |
Glucose-6-phosphate dehydrogenase |
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| Umfang: |
6 |
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| doi: |
10.1055/s-1999-6815 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLEJ227392183 |
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| 245 | 1 | 0 | |a Management of a Case of Chloroquine-Resistant Falciparum Malaria in aPregnant Woman With Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency |
| 264 | 1 | |a Stuttgart ; New York |b Georg Thieme Verlag |c 1999 | |
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| 520 | |a -The available antimalarial drugs for the treatment of Plasmodium falciparum malaria during pregnancy are potentially toxic, expecially in the presence of red blood cells (RBC) defects. We describe a case of chloroquine-resistant malaria by P. falciparum in a pregnant woman with glucose-6-phosphate dehydrogenase (G6PD) deficiency successfully treated with pyrimethamine followed by mefloquine administration. The susceptibility of P. falciparum to chloroquine and mefloquine was assessed by an in vitro test before treatment. Pyrimethamine and mefloquine were administered at the 18th and 22nd week of pregnancy, respectively. Mefloquine concentrations were monitored in the mother's blood at 2, 4, 8, 12, 24 and 48 hr after the administration to define effective blood-drug concentrations. Blood smear examination was negative after 48 hr post mefloquine treatment. No hystologic lesions of the placenta were observed. The newborn presented normal clinical parameters. The administration of pyrimethamine prevented massive placental infection, thus permitting the fetus to achieve suitable gestational age for further treatment with mefloquine to eradicate P. falciparum malaria without deleterious effects to the newborn. Subsequent studies could contribute to define safe administration of mefloquine in G6PD-deficient pregnant woman. | ||
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