Gmür J, Wälti M, Neftel K A
Acta Haematol. 1985;74(4):230-3. doi: 10.1159/000206226.
Severe hemolysis occurred in a 51-year-old female after a 17-day course of intravenous amoxicillin. A strongly positive direct antiglobulin test (anti-IgG titer 1:2,000) ensued which disappeared after withdrawal of the drug. Both the patient's serum and eluate obtained from the patient's red cells contained an IgG antibody which reacted with red blood cells coated in vitro with amoxicillin, but not with uncoated cells. In addition, high-titer antipenicillin, antiampicillin and antiamoxicillin IgG antibodies could be demonstrated in her serum by a RAST-based solid-phase radioimmunoassay. The patient's hemolysis gradually subsided within 1 week after discontinuing the drug. This is the first report of amoxicillin-induced immune hemolytic anemia.
一名51岁女性在静脉注射阿莫西林17天后发生严重溶血。随后直接抗球蛋白试验呈强阳性（抗IgG效价1:2000），停药后该试验结果消失。患者血清以及从患者红细胞中获得的洗脱液均含有一种IgG抗体，该抗体与体外被阿莫西林包被的红细胞发生反应，但不与未包被的细胞发生反应。此外，通过基于放射性变应原吸附试验（RAST）的固相放射免疫测定法可在其血清中检测到高滴度的抗青霉素、抗氨苄西林和抗阿莫西林IgG抗体。停药后1周内患者的溶血逐渐消退。这是阿莫西林诱发免疫性溶血性贫血的首例报告。
