Plasmodium vivax Infection in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

ABSTRACT

Malaria was rarely reported in patients with systemic lupus erythematosus (SLE). We report a case of P. vivax infection in a patient with SLE. A 42-year-old woman was admitted to the hospital because of fever, anemia, and severe thrombocytopenia and had transfusion of multiple blood products including 16 units of red blood cells (RBC). The patient was diagnosed as having SLE complicated with antiphospholipid syndrome. From the 96th hospital day, the patient had cyclic high fever for 4~5 hours, myalgia and shaking chills, follwed by generalized diaphoresis and resolution of fever. Examination of her peripheral blood smear showed gametocytes of P. vivax. She received hydroxychloroquine of a total dose of 25 mg/kg orally over 3 days and then oral primaquine 15 mg/day for 14 days. Blood donors were traced retrospectively. The 13 RBC products were negative for malaria but other three RBC products could not be checked on P. vivax. The patient was presumed to have acquired malaria from infected blood products. Relapse did not occur 1 year later. In conclusion, malaria should be considered in the differential diagnosis of persistent fever in a patients with SLE who received multiple blood products in Korea.