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A Case of Immune Hemolytic Anemia Induced by Ceftizoxime and Cefobactam (Sulbactam/Cefoperazone).

Other Titles
 Ceftizoxime과 Cefobactam에 의한 면역용혈성 빈혈 1예 
Authors
 Eun Jung Baek  ;  Sungsil Lee  ;  Sinyoung Kim  ;  Hyun Kyung Choi  ;  Hyun Ok Kim 
Citation
 KOREAN JOURNAL OF LABORATORY MEDICINE , Vol.29(6) : 578-584, 2009 
Journal Title
 KOREAN JOURNAL OF LABORATORY MEDICINE 
ISSN
 1598-6535 
Issue Date
2009
MeSH
Anemia, Hemolytic/chemically induced ; Anemia, Hemolytic/diagnosis* ; Anemia, Hemolytic/immunology ; Anti-Bacterial Agents/adverse effects* ; Cefoperazone/adverse effects* ; Ceftizoxime/adverse effects* ; Erythrocytes/chemistry ; Erythrocytes/metabolism ; Female ; Humans ; Middle Aged ; Sulbactam/adverse effects*
Keywords
Drug-induced immune hemolytic anemia ; Beta-lactamase inhibitor antibody ; Cephalosporin antibody ; Ceftizoxime antibody
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.
Files in This Item:
T200904914.pdf Download
DOI
10.3343/kjlm.2009.29.6.578
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sin Young(김신영) ORCID logo https://orcid.org/0000-0002-2609-8945
Kim, Hyun Ok(김현옥) ORCID logo https://orcid.org/0000-0002-4964-1963
Baek, Eun Jung(백은정)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105568
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