Severe anaemia with peak parasitemia (~77%) and markedly high lactate (≈19 mmol/L); extensive tissue hypoxia in liver, kidney, and gut; HIF‐1α activation and glycolytic upregulation (↑Glut1, ↑Mct4, ↑lactate production); elevated ALT/AST indicating hepatic injury; hemosiderin deposits in kidney; combined artesunate + blood transfusion restored haematocrit and reduced lactate more effectively than artesunate alone. Here, GPT is linked to anemia.