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Drug-induced immune hemolytic anemia

Definition

Drug-induced immune hemolytic anemia is a blood disorder that occurs when a medicine triggers the body's defense (immune) system to attack its own red blood cells. This causes red blood cells to break down earlier than normal, a process called hemolysis.

Alternative Names

Immune hemolytic anemia secondary to drugs; Anemia - immune hemolytic - secondary to drugs

Causes

Drugs that can cause this type of hemolytic anemia include:

  • Cephalosporins (a class of antibiotics) -- most common cause
  • Dapsone
  • Levodopa
  • Levofloxacin
  • Methyldopa
  • Nitrofurantoin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Penicillin and its derivatives
  • Phenazopyridine (pyridium)
  • Quinidine

Drug-induced hemolytic anemia is rare in children.

Symptoms

  • Dark urine
  • Fatigue
  • Pale skin color
  • Rapid heart rate
  • Shortness of breath
  • Yellow skin color (jaundice)

Exams and Tests

Tests may include:

Treatment

Stopping the drug that is causing the problem may relieve or control the symptoms.

You may need to take a medicine called prednisone to reduce the immune response against the red blood cells. Special blood transfusions may be needed to treat severe symptoms

Outlook (Prognosis)

Possible Complications

Death caused by severe anemia is rare.

When to Contact a Medical Professional

See your health care provider if you have symptoms of this condition.

Prevention

References

Schwartz RS. Autoimmune and intravascular hemolytic Anemias. In: Goldman L, Schafer AI, eds.Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 163.

Jager U, Lechner K. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 44.

Price EA, Schrier SL, Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 45.


Review Date: 3/3/2013
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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