Meyer Oliver, Hoffmann Till, Aslan Tunay, Ahrens Norber, Kiesewetter Holger, Salama Abdulgabar
University Clinic Charité, Institute for Transfusion Medicine, Humboldt University of Berlin, Germany.
Transfusion. 2003 Mar;43(3):345-9. doi: 10.1046/j.1537-2995.2003.00340.x.
Diclofenac has frequently been implicated as the cause of immune hemolytic anemias and less frequently of immune thrombocytopenia. The presence of the causative antibodies has only been demonstrated in patients with immune hemolytic anemia, but not yet in patients with thrombocytopenia. The cases of two patients in whom diclofenac simultaneously induced antibodies against platelets and RBCs are reported.
The investigation was carried out with standard serologic tests for detection of antibodies against platelets and RBCs. The patients' sera were tested in the presence and absence of diclofenac and its metabolites.
One of the two patients developed severe hemolysis and significant thrombocytopenic purpura. The other patient developed significant thrombocytopenia but no hemolysis. Both patients had a positive DAT and drug- and/or metabolite-dependent antibodies against RBCs and platelets.
Based on our findings and those of other investigators, we believe that diclofenac leads to the production of antibodies against RBCs and/or platelets.
双氯芬酸常被认为是免疫性溶血性贫血的病因，而较少被认为是免疫性血小板减少症的病因。仅在免疫性溶血性贫血患者中证实了致病抗体的存在，而在血小板减少症患者中尚未证实。本文报告了两例双氯芬酸同时诱导产生抗血小板和红细胞抗体的病例。
采用标准血清学试验检测抗血小板和红细胞抗体。在有和没有双氯芬酸及其代谢产物的情况下检测患者血清。
两名患者中的一名出现严重溶血和显著的血小板减少性紫癜。另一名患者出现显著的血小板减少但无溶血。两名患者的直接抗人球蛋白试验均为阳性，且存在针对红细胞和血小板的药物和/或代谢产物依赖性抗体。
基于我们的研究结果以及其他研究者的结果，我们认为双氯芬酸会导致产生抗红细胞和/或血小板抗体。
