A case of acute hemolysis after ceftriaxone: immune complex mechanism demonstrated by flow cytometry.
An immune complex mechanism for ceftriaxone sodium- induced severe autoimmune hemolytic anemia has previously been demonstrated using routine blood bank techniques. We describe herein a patient with severe hemolysis that subsided once the drug was discontinued. Serologic techniques demonstrated immune complex-mediated ceftriaxone-dependent red cell antibodies. These findings were further supported by the results of flow cytometry, in which a change in basal red cell autofluorescence was seen in the presence of the antibody and the drug. Our case illustrates the adjunctive value of flow cytometry in the diagnosis of ceftriaxone-dependent red cell antibody.
Kakaiya
Ram
R
LifeSource Blood Services, Glenview, Ill 60025, USA. rkakaiya@itxm.org
Cseri
Jill
J
Smith
Steve
S
Silberman
Simone
S
Rubinas
Tara C
TC
Hoffstadter
Alan
A
D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000139:chemically induced* / Q000209:etiology; D000755:Anemia, Sickle Cell / Q000150:complications*; D000936:Antigen-Antibody Complex / Q000097:blood*; D001803:Blood Transfusion; D002443:Ceftriaxone / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D002648:Child; D004342:Drug Hypersensitivity / Q000097:blood / Q000209:etiology* / Q000276:immunology; D004829:Epilepsy, Generalized / Q000209:etiology; D004912:Erythrocytes / Q000737:chemistry / Q000276:immunology*; D005434:Flow Cytometry; D005453:Fluorescence; D006801:Humans; D008297:Male; D018384:Oxidative Stress; D018410:Pneumonia, Bacterial / Q000150:complications / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000209:etiology
D000936:Antigen-Antibody Complex; D002443:Ceftriaxone