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Immune hemolytic anemia due to cimetidine: the first example of a cimetidine antibody
Author(s) -
Arndt Patricia A.,
Garratty George,
Brasfield Farah M.,
Vemuri Swarajyal L.,
Asuncion Devi J.
Publication year - 2010
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2009.02447.x
Subject(s) - cimetidine , medicine , serology , anemia , antibody , drug , hemolytic anemia , immune system , immunology , gastroenterology , pharmacology
BACKGROUND: Although there have been a few reports of immune hemolytic anemia (IHA) thought to be due to cimetidine, none of them provided proof (e.g., serologic detection of anti‐cimetidine and/or repeat of IHA upon drug rechallenge). One report used cimetidine as an example of how temporal associations of drug administration and hemolytic anemia are not proof of a cause‐effect relationship. STUDY DESIGN AND METHODS: A 63‐year‐old cancer patient developed IHA on two occasions after receiving cimetidine (with and without chemotherapy). Serologic methods included testing cimetidine‐treated red blood cells (RBCs) as well as testing untreated RBCs in the presence of cimetidine. RESULTS: The patient's direct antiglobulin test was positive (C3 only) and a serum antibody to cimetidine was detected by both testing methods. An eluate from the patient's RBCs was nonreactive. Cimetidine‐treated RBCs were optimally prepared at room temperature and needed to be tested on the day of preparation. CONCLUSIONS: This is the first reported case of IHA due to a cimetidine antibody where a drug‐dependent antibody was demonstrated. The patient had IHA after receiving cimetidine on two separate occasions.