American Red Cross Blood Services, Southern California Region, Pomona, California 91768, USA.
Transfusion. 2010 Feb;50(2):302-7. doi: 10.1111/j.1537-2995.2009.02447.x. Epub 2009 Oct 23.
Although there have been a few reports of immune hemolytic anemia (IHA) thought to be due to cimetidine, none of them provided proof (e.g., serologic detection of anti-cimetidine and/or repeat of IHA upon drug rechallenge). One report used cimetidine as an example of how temporal associations of drug administration and hemolytic anemia are not proof of a cause-effect relationship.
A 63-year-old cancer patient developed IHA on two occasions after receiving cimetidine (with and without chemotherapy). Serologic methods included testing cimetidine-treated red blood cells (RBCs) as well as testing untreated RBCs in the presence of cimetidine.
The patient's direct antiglobulin test was positive (C3 only) and a serum antibody to cimetidine was detected by both testing methods. An eluate from the patient's RBCs was nonreactive. Cimetidine-treated RBCs were optimally prepared at room temperature and needed to be tested on the day of preparation.
This is the first reported case of IHA due to a cimetidine antibody where a drug-dependent antibody was demonstrated. The patient had IHA after receiving cimetidine on two separate occasions.
尽管有一些关于免疫性溶血性贫血（IHA）的报道被认为是由于西咪替丁引起的，但没有一个提供了确切的证据（例如，抗西咪替丁的血清学检测和/或药物重新挑战时 IHA 的重复出现）。有一份报告以西咪替丁为例，说明了药物给药与溶血性贫血之间的时间关联并不能证明因果关系。
一位 63 岁的癌症患者在接受西咪替丁（联合或不联合化疗）后两次发生 IHA。血清学方法包括检测西咪替丁处理的红细胞（RBC）以及在存在西咪替丁的情况下检测未经处理的 RBC。
患者的直接抗球蛋白试验阳性（仅 C3），并通过两种检测方法均检测到针对西咪替丁的血清抗体。患者 RBC 的洗脱液无反应性。西咪替丁处理的 RBC 最佳在室温下制备，并且需要在制备当天进行检测。
这是首例因西咪替丁抗体引起的 IHA 病例，其中证明了一种药物依赖性抗体。该患者在两次不同的情况下接受西咪替丁治疗后发生了 IHA。
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