A severe case of cefoxitin-induced immune hemolytic anemia.
Drug-induced immune hemolytic anemia is a rare but underdiagnosed and potentially fatal condition. We report a case of severe hemolytic anemia induced by cefoxitin in a 45-year-old woman admitted with menometrorrhagia. Hemoglobin levels reached a nadir of 4.7 g/dl approximately 72 h after cefoxitin initiation, and hemolysis resolved when cefoxitin was discontinued and prednisone 1 mg/kg was initiated. A transfusion reaction workup revealed no abnormalities. Direct antiglobulin testing was weakly positive with anti-C3. The patient's plasma and RBC eluate reacted with cefoxitin-treated RBCs but not with untreated RBCs in the presence or absence of cefoxitin.
Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
David E
DE
Leaf
Nathaniel B
NB
Langer
Mark
M
Markowski
George
G
Garratty
David L
DL
Diuguid
D000328:Adult; D000743:Anemia, Hemolytic / Q000139:chemically induced*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001803:Blood Transfusion; D002440:Cefoxitin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000097:blood; D008595:Menorrhagia / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002440:Cefoxitin; D011241:Prednisone