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The risk of antimalarials in patients with renal failure

¹ Princess Alexandra Hospital, Harlow, Essex, UK
² The Royal London Hospital, Whitechapel, London, UK
³ Newham University Hospital, London, UK
⁴ Department of Haematological Oncology, St Bartholomew’s Hospital, West Smithfield, London, UK
⁵ St Bartholomew’s Hospital, West Smithfield, London, UK
⁶ Department of Haematological Oncology, St Bartholomew’s Hospital, West Smithfield, London, UK
⁷ Department of Haematological Oncology, St Bartholomew’s Hospital, West Smithfield, London, UK

Correspondence to:
Dr S Agrawal, Department of Haematological Oncology, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK; s.g.agrawal{at}qmul.ac.uk

We present here a patient with end stage renal failure who received two weeks antimalarial prophylaxis at full dose leading to life threatening toxicity with severe acute megaloblastic anaemia, symptomatic pancytopenia and exfoliative dermatitis. Prompt recognition and treatment can rapidly reverse these fatal effects but more importantly, education of patients before travel is imperative in preventing such events.

Keywords: antimalarials; end stage renal failure; exfoliative dermatitis; megaloblastic anaemia; pancytopenia