Immune hemolytic anemia associated with teicoplanin

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2004-01, Vol.44 (1), p.73-76
• Main Authors: Coluccio, Elena, Villa, M. Antonietta, Villa, Emmanuel, Morelati, Fernanda, Revelli, Nicoletta, Paccapelo, Cinzia, Garratty, George, Rebulla, Paolo
• Format: Article
• Language: English
• Subjects: Aged; Anemia, Hemolytic, Autoimmune - chemically induced; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - chemistry; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Coronary Artery Bypass - adverse effects; Coronary Disease - surgery; Humans; Male; Medical sciences; Surgical Wound Infection - drug therapy; Teicoplanin - adverse effects; Teicoplanin - chemistry; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.0041-1132.2003.00599.x

BACKGROUND:  Several drugs can cause immune hemolytic anemia. Here a patient who developed hemolytic anemia after treatment with teicoplanin is described. CASE REPORT:  Owing to a two‐vessel disease, a 68‐year‐old white man underwent coronary artery bypass grafting. He was readmitted for superficial sternal wound infection and sternal instability. Rewiring was required and worsening anemia characterized the course after the reoperation. Drugs used in the second admission were gentamycin, teicoplanin, paracetamol, and codeine. They were considered as a possible cause of drug‐induced hemolytic anemia. RESULTS:  The DAT was positive for complement and IgG. Autoanti‐e was identified in the patient's undiluted serum sample. The eluate was reactive with all RBCs tested only after adding teicoplanin; when diluted 1:4, anti‐e specificity was observed in the presence of teicoplanin. CONCLUSION:  To our knowledge, this is the first report of immune hemolytic anemia owing to teicoplanin.