title: Cefotetan-induced immune hemolytic anemia following prophylaxis for cesarean delivery.
abstract: Second- and third-generation cephalosporins, notably cefotetan, are increasingly implicated in severe, sometimes fatal immunemediated hemolytic anemia. We describe a 26-year-old woman who developed severe hemolytic anemia 2 weeks after receiving a single prophylactic dose of cefotetan during cesarean delivery. The patient's DAT was weakly reactive for IgG and her serum reacted with cefotetan-coated RBCs. The antibody had a titer of 4,096 by antiglobulin testing. The patient required treatment with two units of PRBCs and experienced gradual resolution of hemolysis. Our case emphasizes the need for increased awareness of delayed onset hemolytic anemia following prophylactic use of cefotetan.
authors.affiliation: University of Miami Jackson Memorial Hospital, Holtz Center, Room 2023, 1611 NW 12th Avenue, Miami, Florida, 33136, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shariatmadar
authors.forename: J R
authors.initials: JR
authors.lastname: Storry
authors.forename: L
authors.initials: L
authors.lastname: Sausais
authors.forename: M E
authors.initials: ME
authors.lastname: Reid
mesh_terms: D000327:Adsorption; D000328:Adult; D000743:Anemia, Hemolytic / Q000097:blood / Q000139:chemically induced* / Q000276:immunology; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D015313:Cefotetan / Q000009:adverse effects* / Q000276:immunology; D002585:Cesarean Section; D003298:Coombs Test; D004342:Drug Hypersensitivity / Q000097:blood / Q000209:etiology*; D004910:Erythrocyte Membrane / Q000737:chemistry; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000097:blood / Q000139:chemically induced*; D011183:Postoperative Complications / Q000139:chemically induced* / Q000276:immunology; D011247:Pregnancy
chemical_list: D015313:Cefotetan