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.
Immune hemolytic anemia secondary to drugs; Anemia - immune hemolytic - secondary to drugs
Causes, incidence, and risk factors
In some cases, a drug can cause the immune system to mistakenly think your own red blood cells are dangerous, foreign substances. Antibodies then develop against the red blood cells. The antibodies attach to red blood cells and cause them to break down too early.
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
There are other, rarer causes of drug-induced hemolytic anemia. This includes hemolytic anemia associated with glucose-6 phosphate dehydrogenase (G6PD) deficiency. In this case, the breakdown of red blood cells is due to a certain type of stress in the cell, rather than the body's immune system.
Drug-induced hemolytic anemia is rare in children.
Stopping the drug that is causing the problem may relieve or control the symptoms.
Some persons may be given a medicine called prednisone to reduce the immune response against the red blood cells. Special blood transfusions may be needed to treat severe symptoms.
Expectations (prognosis)
Most patients have a good outcome if they stop taking the drug that is causing the problem.
Complications
Death caused by severe anemia is rare.
Calling your health care provider
See your health care provider if you have symptoms of this condition.
Prevention
You should continue to avoid the drug that caused this condition.
References
Powers A, Silberstein LE. Autoimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr., Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2008:chap 47.
Schrier SL, Price EA. Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr., Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2008:chap 48.
Review Date:
2/28/2011
Reviewed By:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
