Immune hemolytic anemia associated with teicoplanin.
BACKGROUND
Several drugs can cause immune hemolytic anemia. Here a patient who developed hemolytic anemia after treatment with teicoplanin is described.


METHODS
Owing to a two-vessel disease, a 68-year-old white man underwent coronary artery bypass grafting. He was readmitted for superficial sternal wound infection and sternal instability. Rewiring was required and worsening anemia characterized the course after the reoperation. Drugs used in the second admission were gentamycin, teicoplanin, paracetamol, and codeine. They were considered as a possible cause of drug-induced hemolytic anemia.


RESULTS
The DAT was positive for complement and IgG. Autoanti-e was identified in the patient's undiluted serum sample. The eluate was reactive with all RBCs tested only after adding teicoplanin; when diluted 1:4, anti-e specificity was observed in the presence of teicoplanin.


CONCLUSIONS
To our knowledge, this is the first report of immune hemolytic anemia owing to teicoplanin.
Coluccio
Elena
E
Centro Transfusionale e di Immunologia dei Transplanti, IRCCS Ospedale Maggiore, Milan, Italy. ecoluccio@yahoo.it
Villa
M Antonietta
MA
Villa
Emmanuel
E
Morelati
Fernanda
F
Revelli
Nicoletta
N
Paccapelo
Cinzia
C
Garratty
George
G
Rebulla
Paolo
P
D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000139:chemically induced*; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000737:chemistry; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003327:Coronary Disease / Q000601:surgery; D006801:Humans; D008297:Male; D013530:Surgical Wound Infection / Q000188:drug therapy; D017334:Teicoplanin / Q000009:adverse effects* / Q000737:chemistry
D000900:Anti-Bacterial Agents; D017334:Teicoplanin