Ceftriaxone-Induced Immune Hemolytic Anemia: In Vitro Reversal with Peptide Inhibitor of Complement C1 (PIC1)

We report a case of ceftriaxone-induced immune hemolytic anemia in a 10-year-old with chronic active Epstein–Barr virus disease and hemophagocytic lymphohistiocytosis. After chemotherapy, she became febrile and received ceftriaxone. She rapidly developed respiratory failure and anemia. Her direct an...

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Bibliographic Details
Published in:Case reports in hematology 2019, Vol.2019 (2019), p.1-3
Main Authors: Owen, William C., Hair, Pamela S., Kaszowski, Cortney L., Chicella, Michael F., Feagin, Lisa M., Cunnion, Kenji M., Price, Jessica
Format: Article
Language:English
Subjects:
Anemia
Antibiotics
Blood
Case Report
Case reports
Drug dosages
Erythrocytes
Hemoglobin
HIV
Human immunodeficiency virus
Immunoglobulins
Patients
Pediatrics
Peptides
Respiratory failure
Sickle cell disease
Ventilators
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Summary:We report a case of ceftriaxone-induced immune hemolytic anemia in a 10-year-old with chronic active Epstein–Barr virus disease and hemophagocytic lymphohistiocytosis. After chemotherapy, she became febrile and received ceftriaxone. She rapidly developed respiratory failure and anemia. Her direct antiglobulin test was positive for IgG and C3. To confirm this was ceftriaxone-induced complement-mediated hemolysis, we adapted the complement hemolysis using human erythrocytes (CHUHE) assay by adding exogenous ceftriaxone to the patient’s serum which enhanced lysis of her erythrocytes. We confirmed that ceftriaxone initiated a classical complement pathway-mediated hemolysis by in vitro reversal with peptide inhibitor of complement C1 (PIC1).
ISSN:2090-6560
2090-6579
DOI:10.1155/2019/4105653