Trimethoprim-induced immune hemolytic anemia in a pediatric oncology patient presenting as an acute hemolytic transfusion reaction. Pediatr Blood Cancer 2010 Dec 01;55(6):1201-3
Date
07/01/2010Pubmed ID
20589632DOI
10.1002/pbc.22648Scopus ID
2-s2.0-77958535920 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
A 10-year-old male with acute leukemia presented with post-chemotherapy anemia. During red cell transfusion, he developed hemoglobinuria. Transfusion reaction workup was negative. Drug-induced immune hemolytic anemia was suspected because of positive direct antiglobulin test, negative eluate, and microspherocytes on smear pre- and post-transfusion. Drug studies using the indirect antiglobulin test were strongly positive with trimethoprim and trimethoprim-sulfamethoxazole but negative with sulfamethoxazole. The patient recovered after discontinuing the drug, with no recurrence in 2 years. Other causes of anemia should be considered in patients with worse-than-expected anemia after chemotherapy. Furthermore, hemolysis during transfusion is not always a transfusion reaction.
Author List
Gupta S, Piefer CL, Fueger JT, Johnson ST, Punzalan RCAuthor
Rowena C. Punzalan MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anemia, HemolyticAnti-Infective Agents, Urinary
Child
Diagnosis, Differential
Humans
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Transfusion Reaction
Trimethoprim
Trimethoprim, Sulfamethoxazole Drug Combination
