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Trimethoprim‐induced immune hemolytic anemia in a pediatric oncology patient presenting as an acute hemolytic transfusion reaction
Author(s) -
Gupta Sweta,
Piefer Cindy L.,
Fueger Judy T.,
Johnson Susan T.,
Punzalan Rowena C.
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22648
Subject(s) - medicine , hemolytic anemia , trimethoprim , pediatric oncology , immune system , autoimmune hemolytic anemia , anemia , immunology , intensive care medicine , antibiotics , cancer , microbiology and biotechnology , biology
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. Pediatr Blood Cancer. 2010;55:1201–1203. © 2010 Wiley‐Liss, Inc.