Moake J L, Butler C F, Hewell G M, Cheek J, Spruell M A
Transfusion. 1978 May-Jun;18(3):369-73. doi: 10.1046/j.1537-2995.1978.18378205151.x.
A patient with penicillin sensitivity, who had never received a cephalosporin antibiotic previously, developed anemia and spherocytosis following the administration of cefazolin. Hemolysis abated when the drug was discontinued on the fourth day, and recurred on day six when cephalothin therapy was begun. IgG and complement components were present on the patient's erythrocytes, and IgG antibodies in her serum reacted with normal red blood cells which had been coated with benzylpenicillin, cefazolin or cephalothin. Antibodies to cephalothin-coated red blood cells were removed partially by incubating her serum with either benzylpenicillin or cefazolin. Complement-fixing IgG antibodies which reacted with red blood cells coated by cefazolin, cephalothin, and benzylpenicillin were considered to be responsible for hemolysis during the administration of cefazolin and, subsequently, cephalothin. The patient recovered completely following discontinuation of antibiotics, transfusion of red blood cells, and treatment with glucocorticoids. It is concluded that hemolysis may occur during therapy with cefazolin, as well as cephalothin, and may develop rapidly in a patient with penicillin sensitivity.
一名对青霉素过敏且此前从未接受过头孢菌素类抗生素治疗的患者，在使用头孢唑林后出现贫血和球形红细胞增多症。在第四天停用该药后溶血减轻，但在第六天开始使用头孢噻吩治疗时又复发。患者红细胞上存在IgG和补体成分，其血清中的IgG抗体与已用苄青霉素、头孢唑林或头孢噻吩包被的正常红细胞发生反应。通过将她的血清与苄青霉素或头孢唑林孵育，可部分去除针对头孢噻吩包被红细胞的抗体。与头孢唑林、头孢噻吩和苄青霉素包被的红细胞发生反应的补体结合IgG抗体被认为是导致使用头孢唑林及随后头孢噻吩期间溶血的原因。在停用抗生素、输注红细胞并使用糖皮质激素治疗后，患者完全康复。得出的结论是，使用头孢唑林以及头孢噻吩治疗期间可能会发生溶血，并且在对青霉素过敏的患者中可能迅速出现。
