Naidorf J S, Kennedy J M, Becher J W
Department of Emergency Medicine, Osteopathic Medical Center of Philadelphia.
Pediatr Emerg Care. 1990 Mar;6(1):29-32. doi: 10.1097/00006565-199003000-00010.
Methyldopa is an antihypertensive medication which is available generically and under the trade name Aldomet that is widely prescribed in the adult population and infrequently used in children. Methyldopa causes an autoimmune hemolytic anemia in a small percentage of patients who take the drug. We report a case of methyldopa-induced hemolytic anemia in a 15-year-old boy who presented to the emergency department with near-syncope. The boy had been treated with intravenous methyldopa during a trauma admission seven weeks prior to presentation. Evaluation revealed a hemoglobin of three grams, 3+ Coombs' test with polyspecific anti-human globulin and monospecific IgG reagents, and a warm reacting autoantibody. Transfusion and corticosteroid therapy resulted in a complete recovery of the patient. Emergency physicians treating children must be aware of this syndrome in order to diagnose and treat it correctly. A brief review of autoimmune and drug-induced hemolytic anemias is provided.
甲基多巴是一种抗高血压药物，有通用名制剂，也有商品名Aldomet，在成人中广泛使用，在儿童中很少使用。甲基多巴会在一小部分服用该药物的患者中引起自身免疫性溶血性贫血。我们报告一例15岁男孩甲基多巴诱发的溶血性贫血病例，该男孩因接近晕厥状态就诊于急诊科。该男孩在此次就诊前7周因创伤入院期间接受了静脉注射甲基多巴治疗。评估显示血红蛋白为3克，用多特异性抗人球蛋白和单特异性IgG试剂检测库姆斯试验为3+，并有温反应自身抗体。输血和皮质类固醇治疗使患者完全康复。治疗儿童的急诊医生必须了解这种综合征以便正确诊断和治疗。本文对自身免疫性和药物性溶血性贫血进行了简要综述。
