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Investigations revealed signs of severe haemolytic anaemia, with a haemoglobin level of 52\u2009g\/L that reached a nadir of 10\u2009g\/L within 4\u2009hours, in addition to haemoglobinuria, hyperbilirubinaemia and raised lactate dehydrogenase levels. She was diagnosed with post-artemisinin delayed haemolysis, which is usually self-limiting but has the potential to cause severe, life-threatening anaemia 7\u201321 days following malaria treatment with artesunate. There was excellent response to blood transfusion, and the child made a full recovery. This case highlights the importance of providing safety netting advice regarding signs and symptoms of anaemia to patients receiving artesunate, in addition to monitoring of haemoglobin levels in the weeks after treatment.<\/jats:p>","DOI":"10.1136\/bcr-2020-238361","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:14:12Z","timestamp":1678752852000},"page":"e238361","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Delayed haemolysis following artesunate in a child with profound anaemia and Coca-Cola-coloured urine"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9577-8223","authenticated-orcid":false,"given":"Neaha","family":"Patel","sequence":"first","affiliation":[{"name":"Paediatrics Department, Homerton University Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Thomson","sequence":"additional","affiliation":[{"name":"Paediatrics Department, Homerton University Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Re Ferre","sequence":"additional","affiliation":[{"name":"Paediatrics Department, Homerton University Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"2025082706455519000_13.12.e238361.1","unstructured":"Public Health England . 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