Volume 7 Issue 1
Jun.  2023
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Yan Xing, Zebo Yu, Dandan Xu, Tingxi Zhan, Wenjun Que, Jing Wang. A hemolysis verified to be induced by anti-meropenem[J]. Blood&Genomics, 2023, 7(1): 61-66. doi: 10.46701/BG.2023012022028
Citation: Yan Xing, Zebo Yu, Dandan Xu, Tingxi Zhan, Wenjun Que, Jing Wang. A hemolysis verified to be induced by anti-meropenem[J]. Blood&Genomics, 2023, 7(1): 61-66. doi: 10.46701/BG.2023012022028

A hemolysis verified to be induced by anti-meropenem

doi: 10.46701/BG.2023012022028
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  • Corresponding author: Jing Wang, Department of Blood Transfusion, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. E-mail: wjsy86@163.com
  • Received Date: 2022-10-31
  • Rev Recd Date: 2023-01-05
  • Accepted Date: 2023-02-20
  • Available Online: 2023-04-10
  • Publish Date: 2023-06-30
  • Incompatibility of blood groups or unexpected antibodies are primary considerations when acute hemolysis occurs during or after transfusion. However, less attention is paid to drug-induced immune hemolytic anemia (DIIHA), which is a rare but potentially life-threatening autoimmune disease. We present the case of a 34-year-old woman (group A, RhD+) who was treated with multiple antibiotics after meningioma resection. As her hemoglobin (Hb) decreased significantly from 109 g/L to 52 g/L without obvious bleeding, a blood transfusion was conducted soon after the medication, during which acute hemolysis occurred. An unexpected antibody, anti-M (MNS blood group system), was identified in the patient. It was confirmed that both the recipient and donor were group A, M antigen negative (M−) with CCDee phenotype, and no agglutination reactivity was observed in major crossmatch by testing the specimens before and after transfusion. Meanwhile, the results of the direct antiglobulin test (DAT) changed from negative to positive. Anti-meropenem, a drug-dependent antibody of meropenem, was detected, and hemolysis resolved after cessation. Anti-meropenem may mainly act through an "immune complex-type" reaction that induces intravascular hemolysis. Notably, the peculiarity of this case was dependent on the occurrence time of the acute hemolysis. Hence, it is necessary to raise awareness of DIIHA in clinical antibiotic treatments.


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  • [1]
    Elgebaly AS, Fathy SM, Elmorad MB, et al. Blood transfusion and lung surgeries in pediatric age group: a single center retrospective study[J]. Ann Card Anaesth, 2020, 23(2): 149−153. doi: 10.4103/aca.ACA_210_18
    Garratty G. Drug-induced immune hemolytic anemia[J]. Hematology Am Soc Hematol Educ Program, 2009: 73−79. doi: 10.1182/asheducation-2009.1.73
    Renard D, Rosselet A. Drug-induced hemolytic anemia: pharmacological aspects[J]. Transfus Clin Biol, 2017, 24(3): 110−114. doi: 10.1016/j.tracli.2017.05.013
    Salama A. Drug-induced immune hemolytic anemia[J]. Expert Opin Drug Saf, 2009, 8(1): 73−79. doi: 10.1517/14740330802577351
    Oka S, Shiragami H, Nohgawa M. Intravascular hemolytic anemia in a patient with antibodies related to meropenem[J]. Intern Med, 2015, 54(10): 1291−1295. doi: 10.2169/internalmedicine.54.3385
    Garratty G. Immune hemolytic anemia caused by drugs[J]. Expert Opin Drug Saf, 2012, 11(4): 635−642. doi: 10.1517/14740338.2012.678832
    Garratty G, Arndt PA. Drugs that have been shown to cause drug-induced immune hemolytic anemia or positive direct antiglobulin tests: some interesting findings since 2007[J]. Immunohematology, 2014, 30(2): 66−79.
    Leger RM, Arndt PA, Garratty G. How we investigate drug-induced immune hemolytic anemia[J]. Immunohematology, 2014, 30(2): 85−94
    Gniadek TJ, Arndt PA, Leger RM, et al. Drug-induced immune hemolytic anemia associated with anti-vancomycin complicated by a paraben antibody[J]. Transfusion, 2018, 58(1): 181−188. doi: 10.1111/trf.14362
    Okuno T, Kondelis N. Evaluation of dithiothreitol (DTT) for inactivation of IgM antibodies[J]. J Clin Pathol, 1978, 31(12): 1152−1155. doi: 10.1136/jcp.31.12.1152
    Arndt PA. Drug-induced immune hemolytic anemia: the last 30 years of changes[J]. Immunohematology, 2014, 30(2): 44–54.
    Leger RM, Arndt PA, Garratty G. Serological studies of piperacillin antibodies[J]. Transfusion, 2008, 48(11): 2429−2434. doi: 10.1111/j.1537-2995.2008.01852.x
    Garratty G. Review: drug-induced immune hemolytic anemia--the last decade[J]. Immunohematology, 2004, 20(3): 138–146.
    Kumar S, Bansal R, Bansal P, et al. Ceftriaxone-induced hemolytic anemia: a rare case report[J]. Perm J, 2020, 24: 19.088. doi: 10.7812/TPP/19.088
    De Wilde M, Speeckaert M, Callens R, et al. Ceftriaxone-induced immune hemolytic anemia as a life-threatening complication of antibiotic treatment of 'chronic Lyme disease'[J]. Acta Clin Belg, 2017, 72(2): 133−137. doi: 10.1080/17843286.2016.1180829
    Leicht HB, Weinig E, Mayer B, et al. Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature[J]. BMC Pharmacol Toxicol, 2018, 19(1): 67. doi: 10.1186/s40360-018-0257-7
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