title: Pathology consultation on drug-induced hemolytic anemia.
abstract: Drug-induced immune hemolytic anemia is considered to be rare but is likely underrecognized. The consulting pathologist plays a critical role in integrating serologic findings with the clinical history, as drug-induced antibodies should be distinguished as either drug-dependent or drug-independent for appropriate clinical management. Drug-dependent antibodies (DDABs) are most commonly associated with cefotetan, ceftriaxone, and piperacillin, whereas fludarabine, methyldopa, β-lactamase inhibitors, and platinum-based chemotherapeutics are frequent causes of drug-independent antibodies (DIABs). DDABs usually demonstrate a positive direct antiglobulin test and a negative elution, while DIABs are serologically indistinguishable from warm autoantibodies and are similarly steroid-responsive. Drug cessation is always recommended.
authors.affiliation: Puget Sound Blood Center, 921 Terry Ave, Seattle, WA 98104, USA.
authors.forename: Arand
authors.initials: A
authors.lastname: Pierce
authors.forename: Theresa
authors.initials: T
authors.lastname: Nester
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000139:chemically induced* / Q000276:immunology*; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001323:Autoantibodies / Q000276:immunology*; D002511:Cephalosporins / Q000009:adverse effects; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D001323:Autoantibodies; D002511:Cephalosporins