Several Plasmodium vivax relapses after correct primaquine treatment in a patient with impaired cytochrome P450 2D6 function.

Malaria Journal
Alexandra Martin RamírezJosé Miguel Rubio

Abstract

Plasmodium vivax malaria is characterized by the presence of dormant liver-stage parasites, called hypnozoites, which can cause malaria relapses after an initial attack. Primaquine, which targets liver hypnozoites, must be used in combination with a schizonticidal agent to get the radical cure. However, relapses can sometimes occur in spite of correct treatment, due to different factors such as a diminished metabolization of primaquine. In January 2019, a 21 years old woman with residence in Madrid, returning from a trip to Venezuela with clinical symptoms compatible with malaria infection, was diagnosed with vivax malaria. Chloroquine for 3 days plus primaquine for 14 days was the elected treatment. Two months later and after a second trip to Venezuela, the patient presented a second P. vivax infection, which was treated as the previous one. A third P. vivax malaria episode was diagnosed 2 months later, after returning from a trip to Morocco, receiving chloroquine for 3 days but increasing to 28 days the primaquine regimen, and with no more relapses after 6 months of follow up. The genotyping of P. vivax in the three malaria episodes revealed that the same strain was present in the different relapses. Upon confirmation of corr...Continue Reading

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Citations

May 8, 2021·Frontiers in Pharmacology·Rajeev K MehlotraPeter A Zimmerman
May 28, 2021·Clinical Pharmacology and Therapeutics·Guilherme Suarez-Kurtz

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Datasets Mentioned

BETA
AF435639

Methods Mentioned

BETA
PCR
genotyping
electrophoresis

Software Mentioned

ClustalW
Bioedit Sequence Alignment Editor

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