Franchini Massimo, Piccoli Pier Luigi, Gandini Giorgio, Giuffrida Annachiara, Bressan Fausto, De Gironcoli Marzia, Aprili Giuseppe
Servizio di Immunoematologia e Trasfusione, Azienda Ospedaliera di Verona, Italy.
Hematology. 2004 Feb;9(1):65-9. doi: 10.1080/10245330310001638956.
Cephalosporins are frequently associated with positive direct antiglobulin tests (DAT) and may rarely cause immune hemolytic anemia (IHA). We describe a patient who developed hemolytic anemia while she was receiving intravenous cefotetan.
Immunohematologic studies of drug-dependent antibodies were performed by using cefotetan-treated red blood cells (RBCs) and untreated RBCs in the presence of cefotetan.
The patient's serum contained antibodies that reacted with both drug-coated RBCs (adsorption mechanism) and with uncoated RBCs when cefotetan was added to the serum (immune complex mechanism). The prompt recognition of the problem and discontinuation of the drug prevented the onset of renal failure and rapidly resolved the hemolytic reaction.
Our report underlines the importance of close laboratory and immunohematologic monitoring of patients treated with cephalosporins in order to recognize swiftly any hemolytic reaction due to these antibiotics thus reducing the chance of serious sequelae.
头孢菌素常与直接抗球蛋白试验（DAT）阳性相关，且极少可导致免疫性溶血性贫血（IHA）。我们描述了一名在接受静脉注射头孢替坦时发生溶血性贫血的患者。
采用经头孢替坦处理的红细胞（RBC）和在头孢替坦存在下未处理的RBC进行药物依赖性抗体的免疫血液学研究。
患者血清中含有与药物包被的RBC（吸附机制）以及当向血清中加入头孢替坦时与未包被的RBC均发生反应的抗体（免疫复合物机制）。对问题的迅速识别以及药物停用预防了肾衰竭的发生，并迅速解决了溶血反应。
我们的报告强调了对接受头孢菌素治疗的患者进行密切实验室和免疫血液学监测的重要性，以便迅速识别由这些抗生素引起的任何溶血反应，从而减少严重后遗症的发生几率。
