Letona J M, Barbolla L, Frieyro E, Bouza E, Gilsanz F, Fernández M N
Br J Haematol. 1977 Apr;35(4):561-71. doi: 10.1111/j.1365-2141.1977.tb00621.x.
A case of acute immune haemolytic anaemia and renal failure induced by streptomycin, is reported. The clinical features are similar to those in a case previously reported in which no in vitro proof of antibodies was obtained. In this case, streptomycin-specific IgG antibodies, with both k and lambda light chains, could be demonstrated. The streptomycin bound strongly to the red cell membrane, apparently through chemical groups related to the M antigen and possibly also to the D antigen. Complement-fixation by the drug-specific IgG antibodies, after reaction with the streptomycin-coated red cells, could also be demonstrated. On the basis of these findings, our conclusion is that a complement-fixing hapten-cell mechanism was the main cause of the intravascular haemolytic episode suffered by the patient on exposure to streptomycin. This drug had been prescribed 15 years earlier for pulmonary tuberculosis and he had since injected himself with it whenever he felt "flu" symptoms, without harmful effects, until now.
报告了一例由链霉素引起的急性免疫性溶血性贫血和肾衰竭病例。其临床特征与先前报道的一例相似，在该病例中未获得抗体的体外证据。在本病例中，可证明存在具有κ和λ轻链的链霉素特异性IgG抗体。链霉素与红细胞膜紧密结合，显然是通过与M抗原相关的化学基团，也可能与D抗原有关。在与包被链霉素的红细胞反应后，药物特异性IgG抗体的补体结合也得到了证实。基于这些发现，我们的结论是，补体固定半抗原-细胞机制是患者接触链霉素后发生血管内溶血发作的主要原因。该药物早在15年前就被用于治疗肺结核，从那时起，每当他感到有“流感”症状时就自行注射，直到现在都没有出现有害影响。
