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Am. J. Trop. Med. Hyg., 77(1), 2007, pp. 14-15
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Emergency Liver Transplantation in Amodiaquine-Induced Fulminant Hepatitis

Lydia Novisi Markham*, Emiliano Giostra, Antoine Hadengue, Michel Rossier, Michela Rebsamen, AND Jules Desmeules
University Hospitals of Geneva, Geneva, Switzerland

Amodiaquine is an amino-4-quinoline with the basic spectrum of activity of chloroquine. It has been used widely to treat and prevent malaria. From the mid-1980s, there were reports of fatal adverse drug reactions described in travelers using amodiaquine as antimalarial prophylaxis. In 1990, the World Health Organization (WHO) stopped using this drug in malaria control programs. The WHO Expert Committee on Malaria modified this in 1993 and reported that amodiaquine could be used for treatment if the risk of infection outweighs the potential for adverse drug reactions. Currently, amodiaquine is a potential useful drug, especially if used with artemisinin-based combination therapy and with sulfadoxine-pyrimethamine to improve treatment efficacy for chloroquine-resistant strains of Plasmodium falciparum and P. vivax. We report a case of fulminant hepatitis induced by antimalarial prophylactic use of amodiaquine that necessitated emergency orthotopic liver transplantation.

Received August 15, 2006. Accepted for publication February 5, 2007.

Disclosure: The authors have no affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter of this case report.

* Address correspondence to Lydia Novisi Markham, University Hospitals of Geneva, Rue Micheli-du-Crest 24, 1211 Geneva 14, Switzerland. E-mail: markham-lydia{at}diogenes.hcuge.ch

Authors’ addresses: Lydia Novisi Markham, Emiliano Giostra, Antoine Hadengue, Michel Rossier, Michela Rebsamen, and Jules Desmeules, University Hospitals of Geneva, Rue Micheli-du-Crest 24, 1211 Geneva 14, Switzerland, Telephone: 41-22-3723311, Fax: 41-22-3729366, E-mail: markham-lydia{at}diogenes.hcuge.ch.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.