PDF(Pubmed)
Abstract：
UNASSIGNED: Drug-induced immune hemolytic anemia (DIIHA) is a rare but serious condition, with an estimated incidence of one in 100,000 cases, associated with various antibiotics. This study reports on a case of ceftizoxime-induced hemolysis observed in a patient in China.
UNASSIGNED: A Chinese patient diagnosed with malignant rectal cancer underwent antimicrobial therapy after laparoscopic partial recto-sigmoid resection (L-Dixon). After receiving four doses of ceftizoxime, the patient developed symptoms including rash, itchy skin, and chest distress, followed by a rapid decline in hemoglobin levels, the presence of hemoglobin in the urine (hemoglobinuria), renal failure, and disseminated intravascular coagulation. Laboratory analysis revealed high-titer antibodies against ceftizoxime and red blood cells (RBCs) in the patient\'s serum, including immunoglobulin M (IgM) (1:128) antibodies and immunoglobulin G (IgG) (1:8) antibodies, with noted crossreactivity to ceftriaxone. Significant improvement in the patient\'s hemolytic symptoms was observed following immediate discontinuation of the drug, two plasma exchanges, and extensive RBC transfusion.
UNASSIGNED: This case, together with previous reports, underscores the importance of considering DIIHA in patients who exhibit unexplained decreases in hemoglobin levels following antibiotic therapy. A thorough examination of the patient\'s medical history can provide crucial insights for diagnosing DIIHA. The effective management of DIIHA includes immediate cessation of the implicated drug, plasma exchange, and transfusion support based on the identification of specific drug-dependent antibodies through serological testing.
UNASSIGNED: A Chinese patient diagnosed with malignant rectal cancer underwent antimicrobial therapy after laparoscopic partial recto-sigmoid resection (L-Dixon). After receiving four doses of ceftizoxime, the patient developed symptoms including rash, itchy skin, and chest distress, followed by a rapid decline in hemoglobin levels, the presence of hemoglobin in the urine (hemoglobinuria), renal failure, and disseminated intravascular coagulation. Laboratory analysis revealed high-titer antibodies against ceftizoxime and red blood cells (RBCs) in the patient\'s serum, including immunoglobulin M (IgM) (1:128) antibodies and immunoglobulin G (IgG) (1:8) antibodies, with noted crossreactivity to ceftriaxone. Significant improvement in the patient\'s hemolytic symptoms was observed following immediate discontinuation of the drug, two plasma exchanges, and extensive RBC transfusion.
UNASSIGNED: This case, together with previous reports, underscores the importance of considering DIIHA in patients who exhibit unexplained decreases in hemoglobin levels following antibiotic therapy. A thorough examination of the patient\'s medical history can provide crucial insights for diagnosing DIIHA. The effective management of DIIHA includes immediate cessation of the implicated drug, plasma exchange, and transfusion support based on the identification of specific drug-dependent antibodies through serological testing.
摘要：
■药物诱导的免疫性溶血性贫血（DIIHA）是一种罕见但严重的疾病，估计发病率为100,000例中的1例,与各种抗生素有关。本研究报告了在中国一名患者中观察到的头孢唑肟引起的溶血病例。
■一名诊断为恶性直肠癌的中国患者在腹腔镜下部分直肠乙状结肠切除术（L-Dixon）后接受了抗菌治疗。在接受四剂头孢唑肟后，患者出现皮疹等症状,皮肤瘙痒,和胸部窘迫，随后血红蛋白水平迅速下降，尿液中血红蛋白的存在（血红蛋白尿），肾功能衰竭,和弥散性血管内凝血。实验室分析显示，患者血清中存在抗头孢唑肟和红细胞（RBC）的高滴度抗体，包括免疫球蛋白M（IgM）（1:128）抗体和免疫球蛋白G（IgG）（1:8）抗体，与头孢曲松有明显的交叉反应性。立即停药后观察到患者的溶血症状显着改善，两次血浆交换,和大量红细胞输注。
■这种情况下，连同以前的报告，强调了在抗生素治疗后血红蛋白水平出现无法解释的下降的患者中考虑DIIHA的重要性.彻底检查患者的病史可以为诊断DIIHA提供重要的见解。DIIHA的有效管理包括立即停止涉及的药物，血浆置换,和输血支持基于通过血清学检测鉴定特异性药物依赖性抗体。
■一名诊断为恶性直肠癌的中国患者在腹腔镜下部分直肠乙状结肠切除术（L-Dixon）后接受了抗菌治疗。在接受四剂头孢唑肟后，患者出现皮疹等症状,皮肤瘙痒,和胸部窘迫，随后血红蛋白水平迅速下降，尿液中血红蛋白的存在（血红蛋白尿），肾功能衰竭,和弥散性血管内凝血。实验室分析显示，患者血清中存在抗头孢唑肟和红细胞（RBC）的高滴度抗体，包括免疫球蛋白M（IgM）（1:128）抗体和免疫球蛋白G（IgG）（1:8）抗体，与头孢曲松有明显的交叉反应性。立即停药后观察到患者的溶血症状显着改善，两次血浆交换,和大量红细胞输注。
■这种情况下，连同以前的报告，强调了在抗生素治疗后血红蛋白水平出现无法解释的下降的患者中考虑DIIHA的重要性.彻底检查患者的病史可以为诊断DIIHA提供重要的见解。DIIHA的有效管理包括立即停止涉及的药物，血浆置换,和输血支持基于通过血清学检测鉴定特异性药物依赖性抗体。
