Salim Hamza, Musmar Basel, A Sarhan Fajr M, Giacaman Narmeen, Abu Omar Shatha
Department of Medicine, An-Najah National University, Nablus, PSE.
Department of Internal Medicine, Al-Quds University, Abu-Dis, PSE.
Cureus. 2023 Mar 8;15(3):e35915. doi: 10.7759/cureus.35915. eCollection 2023 Mar.
Drugs can have a wide array of effects on hematological cells, including red blood cells (RBCs), white blood cells (WBCs), and platelets. Drug-induced hemolytic anemia (DIHA) can be explained by three different pathophysiological mechanisms. We present a case of a premature neonate born at 34 weeks gestation who was admitted to the neonatal intensive care unit (NICU). He developed respiratory difficulty with mottled skin and was suspected to have bacterial sepsis due to necrotizing enterocolitis (NEC). The patient was eventually started on a broad-spectrum antibiotic, piperacillin-tazobactam. On day eight, the patient started developing jaundice and his hemoglobin level dropped from 12.1 to 8.2 mg/dL. His direct antiglobulin test (DAT) was strongly positive. The patient was suspected to have DIHA. Piperacillin-tazobactam is a commonly used antibiotic for neonatal sepsis, but its potential to cause DIHA in neonates is not well-established. Our case highlights the importance of considering piperacillin-tazobactam as an unrecognized contributor to neonatal jaundice and a potential cause of DIHA in neonates. Further research is needed to explore the extent of its involvement in this condition. Physicians should be cautious when administering this drug to neonates and be aware of the possibility of hemolysis and jaundice.
药物可对血液学细胞产生广泛影响，包括红细胞（RBC）、白细胞（WBC）和血小板。药物性溶血性贫血（DIHA）可由三种不同的病理生理机制来解释。我们报告一例孕34周出生的早产儿，该患儿入住新生儿重症监护病房（NICU）。他出现呼吸困难且皮肤有斑点，因坏死性小肠结肠炎（NEC）而怀疑患有细菌性败血症。该患者最终开始使用广谱抗生素哌拉西林 - 他唑巴坦。在第8天，患者开始出现黄疸，其血红蛋白水平从12.1降至8.2mg/dL。他的直接抗球蛋白试验（DAT）呈强阳性。该患者被怀疑患有DIHA。哌拉西林 - 他唑巴坦是新生儿败血症常用的抗生素，但其在新生儿中导致DIHA的可能性尚未明确。我们的病例强调了将哌拉西林 - 他唑巴坦视为新生儿黄疸未被认识的原因以及新生儿DIHA潜在病因的重要性。需要进一步研究以探讨其在这种情况中的参与程度。医生在给新生儿使用这种药物时应谨慎，并意识到溶血和黄疸的可能性。
