drug-induced hemolytic anemia
Jump to navigation
Jump to search
Introduction
(may be IgG or IgM) [refs. 1 & 2]
Etiology
- aminosalicyclic acid
- cephalosporins (especially 3rd generation)
- chlorpromazine
- dapsone
- insulin
- isoniazid
- levodopa
- mefenamic acid
- melphalan
- methyldopa
- penicillins
- phenacetin
- procainamide
- quinidine
- rifampin
- sulfonamides
Epidemiology
10% of patients with autoimmune hemolytic anemia
Laboratory
- laboratory evidence of hemolytic anemia
- elevated unconjugated (indirect) bilirubin
- elevated serum lactate dehydrogenase (LDH)
- positive direct antiglobulin test (DAT)
- route tests for erythrocyte antibodies are negative
- an eluate from the patient's erythrocytes are NOT reactive with normal erythrocytes
- indirect antiglobulin test (Coomb's) is positive when erythrocytes coated with the drug are incubated with the patient's serum
- reticulocyte count generally elevated*
- MCV generally elevated*
* no additional conditions present impairing erythropoiesis[3]
More general terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 579-80
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 18, 19. American College of Physicians, Philadelphia 1998, 2018, 2022.
- ↑ Mayer B, Bartolmas T, Yurek S, Salama A. Variability of Findings in Drug-Induced Immune Haemolytic Anaemia: Experience over 20 Years in a Single Centre. Transfus Med Hemother. 2015 Sep;42(5):333-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26696803 Free PMC Article