A case of recurrent subacute disseminated intravascular coagulation associated with malarial prophylaxis

An adult male who twice presented with a sudden haemolytic anaemia and disseminated intravascular coagulation of uncertain aetiology is described. A possible causative agent common to both episodes is the breakdown product of pyrimethamine (Daraprim) and chlorguanide (Paludring). A very similar case has been attributed to penicillin sensitivety. The usefulness of high dosage heparin in the treatment of the subacute form of disseminated intravascualr coagulation is illustrated in the first admission.