Ceftriaxone-related hemolysis and acute renal failure.
A 5-year-old girl with no underlying immune deficiency or hematologic disease was treated with a combination of ceftriaxone and ampicilline-sulbactam for pneumonia. On the ninth day of the therapy, she developed oliguria, paleness, malaise, immune hemolytic anemia (IHA) and acute renal failure (ARF). Laboratory studies showed the presence of antibodies against ceftriaxone. Acute interstitial nephritis (AIN) was diagnosed by renal biopsy. The patient's renal insufficiency was successfully treated with peritoneal dialysis without any complications. The patient recovered without any treatment using steroids or other immunosuppressive agents.
Demirkaya
Erkan
E
Department of Pediatric Nephrology, Gulhane Military Medical Academy, 06018, Etlik, Ankara, Turkey. dottore_erkan@yahoo.com
Atay
Abdullah Avni
AA
Musabak
Ugur
U
Sengul
Ali
A
Gok
Faysal
F
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D000667:Ampicillin / Q000009:adverse effects; D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002443:Ceftriaxone / Q000009:adverse effects*; D002675:Child, Preschool; D003298:Coombs Test; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D010530:Peritoneal Dialysis; D011014:Pneumonia / Q000188:drug therapy; D013407:Sulbactam / Q000009:adverse effects; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007074:Immunoglobulin G; C035444:sultamicillin; D002443:Ceftriaxone; D000667:Ampicillin; D013407:Sulbactam