Branch D R, Berkowitz L R, Becker R L, Robinson J, Martin M, Gallagher M T, Petz L D
Am J Hematol. 1985 Feb;18(2):213-9. doi: 10.1002/ajh.2830180213.
Hemolytic anemia occurred in a 70-year-old female after a five-day course of intravenous cefamandole. The patient's serum contained an IgG antibody which was reactive with red blood cells which had been coated in vitro with cefamandole but not with uncoated cells. An in vitro assay of allogeneic mononuclear phagocytosis of cefamandole-coated red cells sensitized with the patient's anti-cefamandole indicated that the anti-cefamandole could induce significant phagocytosis. The anti-cefamandole was easily inhibited in vitro by cefamandole as well as by a variety of related cephalosporins indicating broad cross-reactivity, with the antigenic site primarily the 7-amino-cephalosporanic acid nucleus. Penicillins could inhibit the anti-cefamandole but only when using concentrations 3-10 X those of cephalosporins. Eleven examples of anti-penicillin tested failed to react with cefamandole-coated red cells. Screening of 344 random sera from hospitalized patients found only five (1.5%) reactive with cefamandole-coated red cells; three of these sera were also reactive with penicillin-coated red cells. The patient's hemolysis subsided following cessation of the drug. This is the first report of anti-cefamandole-induced hemolytic anemia.
一名70岁女性在静脉注射头孢孟多五天后发生溶血性贫血。患者血清中含有一种IgG抗体，该抗体与体外被头孢孟多包被的红细胞发生反应，但不与未包被的细胞发生反应。对用患者的抗头孢孟多致敏的头孢孟多包被红细胞进行的同种异体单核吞噬细胞体外测定表明，抗头孢孟多可诱导显著的吞噬作用。头孢孟多以及多种相关头孢菌素在体外很容易抑制抗头孢孟多，这表明存在广泛的交叉反应性，抗原位点主要是7-氨基头孢烷酸核。青霉素可以抑制抗头孢孟多，但只有在使用浓度为头孢菌素3至10倍时才有效。对11份抗青霉素检测样本进行检测，结果显示它们与头孢孟多包被的红细胞无反应。对344份住院患者的随机血清进行筛查，发现只有5份（1.5%）与头孢孟多包被的红细胞发生反应；其中3份血清也与青霉素包被的红细胞发生反应。停药后患者的溶血症状消退。这是关于抗头孢孟多诱导的溶血性贫血的首次报告。
