Immune hemolytic anemia associated with streptococcal preparation OK-432.
In the course of administration of an immunopotentiator, streptococcal agent OK-432, a patient with lung cancer was found to have severe anemia and a strongly positive antiglobulin test. In the absence of the drug, eluates from the patient's erythrocytes reacted strongly by the indirect antiglobulin test with a panel of washed Group O erythrocyte samples. The eluated antibody was composed of monoclonal IgG1-lambda. Upon discontinuing the drug the patient's hemoglobin level increased slowly with concomitant normalization of the reticulocyte count. Although very rare, drug-induced immune hemolytic anemia should be included in the list of adverse effects of immunopotentiators. This is the first reported case of immune hemolytic anemia associated with OK-432.
D000368:Aged; D000743:Anemia, Hemolytic / Q000209:etiology*; D000911:Antibodies, Monoclonal / Q000032:analysis; D001688:Biological Products / Q000009:adverse effects*; D001788:Blood Grouping and Crossmatching; D018288:Carcinoma, Small Cell / Q000628:therapy; D006242:Haptoglobins / Q000032:analysis; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000628:therapy; D008297:Male; D010844:Picibanil / Q000009:adverse effects*; D012698:Serologic Tests
D000911:Antibodies, Monoclonal; D001688:Biological Products; D006242:Haptoglobins; D006454:Hemoglobins; D010844:Picibanil; D007770:L-Lactate Dehydrogenase