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- Title
Ceftizoxime-induced hemolysis secondary to combined drug adsorption and immune-complex mechanisms.
- Authors
Calhoun, Beverly W.; Junsanto, Tipsuda; De Tolve Donoghue, Maria; Naureckas, Edward; Baron, Joseph M.; Baron, Beverly W.; Calhoun, B W; Junsanto, T; Donoghue, M T; Naureckas, E; Baron, J M; Baron, B W
- Abstract
<bold>Background: </bold>Immune hemolytic anemia has been associated with the administration of various antibiotics, including cephalosporins. Presented here is a patient who developed severe acute hemolysis while receiving ceftizoxime (Ceftizox, Fujisawa USA), a third-generation cephalosporin. This is the fourth reported case of hemolysis in association with ceftizoxime. In the previous cases, ceftizoxime was shown to induce hemolysis by the immune-complex mechanism. However, in one of those reports, the concentration of drug used to treat the target RBCs in vitro may not have been optimal.<bold>Case Report: </bold>The patient's antemortem blood samples were analyzed retrospectively for drug-dependent antibodies by the drug-adsorption and immune-complex methods. Antibody class and titer were evaluated.<bold>Results: </bold>The patient's sample agglutinated RBCs coated with ceftizoxime as well as uncoated RBCs in the presence of ceftizoxime. The antibodies to ceftizoxime were IgM and IgG.<bold>Conclusion: </bold>This is the first report on both the immune-complex and drug-adsorption mechanisms of ceftizoxime-induced hemolysis. The differential diagnosis of a falling Hct in a patient receiving antibiotics should include drug-related hemolysis; once this diagnosis is considered, management includes the appropriate serologic workup, immediate cessation of the implicated drugs, and possible transfusion support.
- Subjects
CHOLANGIOCARCINOMA; HEMOLYSIS &; hemolysins
- Publication
Transfusion, 2001, Vol 41, Issue 7, p893
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1046/j.1537-2995.2001.41070893.x