Abstract
We report a patient with fulminant Lassa fever who responded dramatically to a 2.5-litre exchange transfusion of whole blood. On admission he was semicomatose with facial oedema and oral haemorrhage; his platelets showed markedly depressed aggregation to ADP; and his plasma inhibited the aggregation responses of normal platelets in vitro. Exchange transfusion resulted in rapid clinical improvement, recovery of platelet function, and disappearance of platelet-inhibitory activity in plasma. The patient died 2 weeks later from an acute encephalopathy. His initial response was sufficiently impressive to suggest that further evaluation of this therapeutic approach is justified in selected patients with overwhelming Lassa virus infection.
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- Cummins D., Fisher-Hoch S. P., Walshe K. J., Mackie I. J., McCormick J. B., Bennett D., Perez G., Farrar B., Machin S. J. A plasma inhibitor of platelet aggregation in patients with Lassa fever. Br J Haematol. 1989 Aug;72(4):543–548. doi: 10.1111/j.1365-2141.1989.tb04321.x. [DOI] [PubMed] [Google Scholar]
- Fisher-Hoch S. P., Price M. E., Craven R. B., Price F. M., Forthall D. N., Sasso D. R., Scott S. M., McCormick J. B. Safe intensive-care management of a severe case of Lassa fever with simple barrier nursing techniques. Lancet. 1985 Nov 30;2(8466):1227–1229. doi: 10.1016/s0140-6736(85)90752-4. [DOI] [PubMed] [Google Scholar]
- Frame J. D., Verbrugge G. P., Gill R. G., Pinneo L. The use of Lassa fever convalescent plasma in Nigeria. Trans R Soc Trop Med Hyg. 1984;78(3):319–324. doi: 10.1016/0035-9203(84)90107-x. [DOI] [PubMed] [Google Scholar]
- Leifer E., Gocke D. J., Bourne H. Lassa fever, a new virus disease of man from West Africa. II. Report of a laboratory-acquired infection treated with plasma from a person recently recovered from the disease. Am J Trop Med Hyg. 1970 Jul;19(4):677–679. doi: 10.4269/ajtmh.1970.19.677. [DOI] [PubMed] [Google Scholar]
- McCormick J. B., King I. J., Webb P. A., Johnson K. M., O'Sullivan R., Smith E. S., Trippel S., Tong T. C. A case-control study of the clinical diagnosis and course of Lassa fever. J Infect Dis. 1987 Mar;155(3):445–455. doi: 10.1093/infdis/155.3.445. [DOI] [PubMed] [Google Scholar]
- McCormick J. B., King I. J., Webb P. A., Scribner C. L., Craven R. B., Johnson K. M., Elliott L. H., Belmont-Williams R. Lassa fever. Effective therapy with ribavirin. N Engl J Med. 1986 Jan 2;314(1):20–26. doi: 10.1056/NEJM198601023140104. [DOI] [PubMed] [Google Scholar]
- Roberts P. J., Cummins D., Bainton A. L., Walshe K. J., Fisher-Hoch S. P., McCormick J. B., Gribben J. G., Machin S. J., Linch D. C. Plasma from patients with severe Lassa fever profoundly modulates f-met-leu-phe induced superoxide generation in neutrophils. Br J Haematol. 1989 Oct;73(2):152–157. doi: 10.1111/j.1365-2141.1989.tb00245.x. [DOI] [PubMed] [Google Scholar]
- Walker D. H., McCormick J. B., Johnson K. M., Webb P. A., Komba-Kono G., Elliott L. H., Gardner J. J. Pathologic and virologic study of fatal Lassa fever in man. Am J Pathol. 1982 Jun;107(3):349–356. [PMC free article] [PubMed] [Google Scholar]