Reactions 1704, p90 - 2 Jun 2018 Drug induced immune haemolytic anaemia: case report A 23-year-old woman developed drug induced immune haemolytic anaemia (DIIHA) during treatment with The woman, who had cystic fibrosis (CF), chronically infected with Pseudomonas aeruginosa presented with a two week history of increasing shortness of breath, general malaise, decline in forced expiratory volume and a productive cough. She started in-patient treatment for a pulmonary exacerbation and was initiated on a 14 day course of IV ceftazidime 3g [frequency not stated] and colistimethate sodium. After the initial improvement, on day 4, she developed hypotension, new pyrexia, jaundice and tachycardia, and had a requirement of increased oxygen without new chest X-ray changes. On same day, laboratory investigations revealed severe haemolytic anaemia, hyper-bilirubinaemia and elevated lactate dehydrogenase. Haptoglobin was undetectable. Subsequently, she developed a reticulocytosis. A direct Coomb’s test was strongly positive, confirming the presence of RBC directed antibodies. A diagnosis of ceftazidime-induced DIIHA was made. The woman’s therapy with ceftazidime and colistimethate sodium was stopped, and two units of packed RBCs were transfused with parenteral steroid cover. Subsequently, she started receiving prednisolone, which continued induction of remission. Additionally, she was started on folic acid. She improved significantly both biochemically and clinically. Within 10 days, her haemoglobin recovered to 100 g/L. Author comment: "[W]e present a case of DIIHA secondary to intravenous (IV) ceftazidime use in a person with CF." Yong J, et al. Case Report: Haemolytic anaemia with ceftazidime use in a patient with cystic fibrosis [version 1; referees: 2 approved]. F1000 Research 7: 475, Apr 2018. Available from: URL: http://doi.org/10.12688/f1000research.14505.1 - United Kingdom 803323130 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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