A Case of Immune Hemolytic Anemia Induced by Ceftizoxime and Cefobactam (Sulbactam/Cefoperazone) / 대한진단검사의학회지
The Korean Journal of Laboratory Medicine
;
: 578-584, 2009.
Article
in English
| WPRIM
| ID: wpr-106756
ABSTRACT
Simultaneous drug-induced immune hemolytic anemia (DIIHA) caused by multiple drugs is rare. We report a case of a patient who developed DIIHA caused by 2 drugs. The patient's serum exhibited agglutination of ceftizoxime- or sulbactam-coated red blood cells (RBCs; via a drug-adsorption mechanism) and of uncoated RBCs in the presence of sulbactam (via an immune-complex mechanism). Although ceftizoxime is known to exhibit a positive reaction by an immune-complex method with or without reactivity with drug-coated RBCs, this patient's antibodies were reactive only against drug-coated RBCs. On the other hand, sulbactam, which is known to cause hemolytic anemia by nonimmunologic protein adsorption, exhibited positive reactions in tests with both drug-coated RBCs and in the presence of sulbactam. This is the first report of DIIHA due to a sulbactam-cefoperazone combination and the fourth report of DIIHA due to ceftizoxime. Owing to the patient's complicated laboratory results, DIIHA was suspected only at a late stage. We propose that for the prompt diagnosis of DIIHA, tests for all possible causative drugs should be conducted by 2 methods.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Ceftizoxime
/
Sulbactam
/
Cefoperazone
/
Erythrocytes
/
Anemia, Hemolytic
/
Anti-Bacterial Agents
Limits:
Female
/
Humans
Language:
English
Journal:
The Korean Journal of Laboratory Medicine
Year:
2009
Type:
Article
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