Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Acta Haematol. 2010;124(4):197-9. doi: 10.1159/000320169. Epub 2010 Nov 2.
Drug-induced immune hemolytic anemia is a rare but underdiagnosed and potentially fatal condition. We report a case of severe hemolytic anemia induced by cefoxitin in a 45-year-old woman admitted with menometrorrhagia. Hemoglobin levels reached a nadir of 4.7 g/dl approximately 72 h after cefoxitin initiation, and hemolysis resolved when cefoxitin was discontinued and prednisone 1 mg/kg was initiated. A transfusion reaction workup revealed no abnormalities. Direct antiglobulin testing was weakly positive with anti-C3. The patient's plasma and RBC eluate reacted with cefoxitin-treated RBCs but not with untreated RBCs in the presence or absence of cefoxitin.
药物诱导的免疫性溶血性贫血是一种罕见但诊断不足且可能致命的疾病。我们报告了一例 45 岁女性因头孢西丁引起的严重溶血性贫血病例，该患者因月经过多入院。在开始使用头孢西丁约 72 小时后，血红蛋白水平降至最低点 4.7 g/dl，当停止使用头孢西丁并开始使用 1 mg/kg 的泼尼松龙后，溶血得到缓解。输血反应检查无异常。直接抗球蛋白试验呈弱阳性，与抗 C3 反应。在存在或不存在头孢西丁的情况下，患者的血浆和 RBC 洗脱液与头孢西丁处理的 RBC 反应，但与未处理的 RBC 不反应。
