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Extravascular hemolysis following the administration of cefamandole
Author(s) -
Branch Donald R.,
Berkowitz Lee R.,
Becker Robert L.,
Robinson Judy,
Martin Marsha,
Gallagher Michael T.,
Petz Lawrence D.
Publication year - 1985
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830180213
Subject(s) - cefamandole , hemolysis , cephalosporin , phagocytosis , in vitro , medicine , microbiology and biotechnology , hemolytic anemia , red cell , penicillin , peripheral blood mononuclear cell , chemistry , antibody , immunology , pharmacology , antibiotics , biochemistry , biology
Hemolytic anemia occurred in a 70‐year‐old female after a five‐day course of intravenous cefamandole. The patient's serum contained an IgG antibody which was reactive with red blood cells which had been coated in vitro with cefamandole but not with uncoated cells. An in vitro assay of allogeneic mononuclear phagocytosis of cefamandole‐coated red cells sensitized with the patient's anticefamandole indicated that the anticefamandole could induce significant phagocytosis. The anticefamandole was easily inhibited in vitro by cefamandole as well as by a variety of related cephalosporins indicating broad cross‐reactivity, with the antigenic site primarily the 7‐amino‐cephalosporanic acid nucleus. Penicillins could inhibit the anticefamandole but only when using concentrations 3‐10× those of cephalosporins. Eleven examples of antipenicillin tested failed to react with cefamandole‐coated red cells. Screening of 344 random sera from hospitalized patients found only five (1.5%) reactive with cefamandole‐coated red cells; three of these sera were also reactive with penicillin‐coated red cells. The patient's hemolysis subsided following cessation of the drug. This is the first report of anticefamandole‐induced hemolytic anemia.