Nishiyama M, Koh T, Kabutomori O, Yanagihara T
Central Laboratory for Clinical Investigation, Osaka University Hospital, Suita.
Rinsho Byori. 1997 May;45(5):498-500.
We observed red blood cell (RBC) agglutination on peripheral blood smear and an abnormal RBC distribution histogram that suggested the influence of cefpirom sulfate. The patient was receiving cefpirom sulfate when RBC agglutination and the abnormal pattern were recognized, but these abnormalities disappeared as soon as the drug was withdrawn. When the peripheral blood sample was re-examined after warming for an hour at 37 degrees C, the abnormal pattern almost disappeared and RBC agglutination became minimal. We also observed cold agglutination reaction by using O type washed RBCs from a healthy individual that were reacted with cefpirom sulfate, but found only minimal agglutination at RT. As the drug concentration and plasma concentration were increased, we observed more agglutination at 4 degrees C, but this agglutination disappeared after incubation for an hour at 37 degrees C. The cold agglutinin titer was normal. We thus believe that the cause of RBC agglutination in this case was caused by cefpirom sulfate.
我们在外周血涂片上观察到红细胞（RBC）凝集以及异常的红细胞分布直方图，提示硫酸头孢匹罗的影响。在识别出红细胞凝集和异常模式时，患者正在接受硫酸头孢匹罗治疗，但停药后这些异常情况立即消失。当外周血样本在37℃温育1小时后重新检查时，异常模式几乎消失，红细胞凝集变得轻微。我们还使用来自健康个体的O型洗涤红细胞与硫酸头孢匹罗反应观察到冷凝集反应，但在室温下仅发现轻微凝集。随着药物浓度和血浆浓度增加，我们在4℃观察到更多凝集，但在37℃温育1小时后这种凝集消失。冷凝集素滴度正常。因此，我们认为该病例中红细胞凝集的原因是由硫酸头孢匹罗引起的。
