Treated as IDA, but turned out to be P. VIVAX induced anemia

A 25 year old female who was being treated as case of IDA for last 2 months, reported to OPD with complaints of extreme weakness and lethargy History She was started treatment as per line of iron deficiency anemia and given iron sucrose 6 infusions followed by tablets, but even after two months it didnt improve Investigations Feb 2021 Hb - 6.7 Rbc count - 2.85 April 2021 Hb - 6.3 Rbc count - 2.57 Seeing a hemolytic picture, I did MP by RDT, which was negative and upon GBP, pathologist reported P. vivax Management My concern is - In this case, I will not be able to give primaquine at all, as HB is low How to deal with low HB even after giving treatment for P. Vivax??

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SUGGESTIVE. OF UNTREATED ....P. VIVAX. . MALARIA . INDUCED .. SEVERE. HEMOLYTIC ANAEMIA ADVISABLE 1. BLOOD. TRANSFUSION AT. LEAST. THREE. UNITS... ( EACH. ...... 12. HOURLY. ) 2. ARTHEMETER. PLUS... I. TAB...... B D. × 3. DAYS 3. DOLO..... IF. FEVER... 4. I / V. ANTIBIOTICS...... IF. SECONDARY. INFECTION. 5. ALL. .ROUTINE. EVALUATION

NEED'S.. ANEMIA PROFILE.. BT .. HEMATINIC'S.. SYMPTOMATIC T/T..

1 st increase HB level by 2 units of blood transfusion then treatment of malaria

After treatment of p vivax To increase hb one option is BT

Thanx dr Dinesh Gupta
1

PBS, sr iron tibc & stool occult blood,why did you suspect hemolytic anaemia

Blood transfusions at least one unit on prior basic and then parallel give antibiotics iv