title: [A case of red blood cell(RBC) agglutination on peripheral blood smear and effect of cefpirom sulfate].
abstract: 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RBC agglutination and the abnormal pattern were recognized, but these abnormalities disappeared as soon as the drug was withdrawn.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.
authors.affiliation: Central Laboratory for Clinical Investigation, Osaka University Hospital, Suita.
authors.forename: M
authors.initials: M
authors.lastname: Nishiyama
authors.forename: T
authors.initials: T
authors.lastname: Koh
authors.forename: O
authors.initials: O
authors.lastname: Kabutomori
authors.forename: T
authors.initials: T
authors.lastname: Yanagihara
mesh_terms: D002478:Cells, Cultured; D002511:Cephalosporins / Q000009:adverse effects*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004903:Erythrocyte Aggregation / Q000187:drug effects*; D006801:Humans; D008297:Male; D013696:Temperature; D000097572:Cefpirome
chemical_list: D002511:Cephalosporins; D000097572:Cefpirome