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万古霉素诱导的溶血性贫血

Vancomycin-Induced Hemolytic Anemia.

作者信息

Siddiqui Fakeha, Cheema Ahmad, Kamran Amir

机构信息

Internal Medicine, Camden Clark Medical Center, Parkersburg, USA.

Hematology-Oncology, West Virginia University, Morgantown, USA.

出版信息

Cureus. 2023 May 18;15(5):e39191. doi: 10.7759/cureus.39191. eCollection 2023 May.

Abstract

Drug-induced hemolytic anemia is rare and can occur either by an immune-mediated mechanism or a non-immune-mediated mechanism. The drugs most frequently associated with immune-mediated hemolysis are penicillins and cephalosporins. It is usually difficult to distinguish drug-induced hemolysis from other more common causes of hemolysis; therefore, a high index of clinical suspicion is required to make the diagnosis. In this case report, we present a case of vancomycin-induced immune hemolytic anemia in a 75-year-old patient who developed hemolytic anemia after starting vancomycin for joint infection. Hematological parameters improved after the discontinuation of vancomycin. Mechanism and management of drug-induced immune hemolytic anemia are also reviewed in this report.

摘要

药物性溶血性贫血较为罕见,可通过免疫介导机制或非免疫介导机制发生。与免疫介导性溶血最常相关的药物是青霉素和头孢菌素。通常很难将药物性溶血与其他更常见的溶血原因区分开来;因此,需要高度的临床怀疑指数才能做出诊断。在本病例报告中,我们介绍了一名75岁患者发生万古霉素诱导的免疫性溶血性贫血的病例,该患者在因关节感染开始使用万古霉素后出现溶血性贫血。停用万古霉素后血液学参数有所改善。本报告还对药物性免疫性溶血性贫血的机制和管理进行了综述。

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