Hematology and Oncology Book

Hemolytic Disorders

Tranfusion

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Drug-Induced Hemolytic Anemia

Aka: Drug-Induced Hemolytic Anemia, Drug Induced Immune-Mediated Hemolysis, Medication Causes of Hemolytic Anemia
  1. See Also
    1. Medications in G6PD Deficiency
  2. Differential Diagnosis
    1. See Hemolytic Anemia
    2. Autoimmune Hemolytic Anemia
    3. Methemoglobinemia
    4. G6PD Deficiency
  3. Mechanisms
    1. Drug-absorption or hapten-induced
      1. Medication coats Red Blood Cell surface
      2. Induces IgG Antibody production
    2. Immune-complex
      1. Drug stimulates IgM production and binding
      2. Drug-IgM complex binds RBC and complement induced
    3. Autoantibody
      1. Drug stimulates IgG production against RBC membrane
  4. Causes: Positive Anti-IgG (Extravascular Hemolysis)
    1. Alpha-Methyldopa
    2. Ampicillin
    3. Carbenicillin
    4. Diclofenac
    5. Ibuprofen
    6. Interferon alfa
    7. Levodopa
    8. Mefenamic acid
    9. Methicillin
    10. Penicillin
    11. Procainamide
  5. Causes: Positive Anti-C3 (Intravascular Hemolysis)
    1. Acetaminophen
    2. Chlorpromazine
    3. Fluorouracil
    4. Hydrochlorothiazide
    5. Hydralazine
    6. Insulin
    7. Isoniazid
    8. Melphalan
    9. Phenacetin
    10. Probenacid
    11. Quinidine
    12. Quinine
    13. Rifampin
    14. Streptomycin
    15. Sulfonamides
    16. Sulindac
    17. Tetracycline
  6. References
    1. Ford (2001) Clinical Toxicology, p. 201-3
    2. Dhaliwal (2004) Am Fam Physician 69:2599-606 [PubMed]
    3. Lubran (1989) Ann Clin Lab Sci 19:114-21 [PubMed]

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