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Her results on admission revealed an anaemia (haemoglobin 43\u2009g\/L), raised lactate dehydrogenase and positive direct antiglobulin test that suggested an intravascular haemolytic process. She made a capacitous decision to refuse blood products in line with her personal beliefs. Despite best supportive treatment, she did not survive. This case highlights the importance of postartemisinin follow-up and should encourage discussion and careful consideration of its use in the context of lack of access to\/patient refusal of blood products.<\/jats:p>","DOI":"10.1136\/bcr-2021-245718","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T10:37:35Z","timestamp":1637318255000},"page":"e245718","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Fatal case of delayed-onset haemolytic anaemia after oral artemether\u2013lumefantrine"],"prefix":"10.1136","volume":"14","author":[{"given":"Lotta","family":"Gustafsson","sequence":"first","affiliation":[{"name":"Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2942-3635","authenticated-orcid":false,"given":"Sunil","family":"James","sequence":"additional","affiliation":[{"name":"Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0268-025X","authenticated-orcid":false,"given":"Karunakaran Pradeep","family":"Thozhuthumparambil","sequence":"additional","affiliation":[{"name":"Department of Acute medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"2025082709391745000_14.11.e245718.1","unstructured":"World Health Organization . 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