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Levofloxacin-induced autoimmune hemolytic anemia
Young R Oh1, Sian M Carr-Lopez, James M Probasco
1Department of Clinical Pharmacy Services, David Grant USAF Medical Center, Travis Air Force Base, CA, USA. young.oh@60mdg.travis.af.mil
The Annals of Pharmacotherapy
|July 5, 2003
Summary
Levofloxacin can cause autoimmune hemolytic anemia (AIHA), a rare but serious adverse drug event. Promptly stopping the antibiotic and treating the anemia is crucial for patient recovery.
Area of Science:
- Pharmacovigilance
- Hematology
- Immunology
Background:
- Levofloxacin is a commonly prescribed fluoroquinolone antibiotic.
- Autoimmune hemolytic anemia (AIHA) is a condition where the immune system attacks red blood cells.
Observation:
- An 82-year-old male developed severe jaundice, dizziness, and vision loss after levofloxacin treatment for cellulitis.
- Diagnosis of AIHA secondary to levofloxacin was confirmed.
- The patient recovered after discontinuation of levofloxacin, red blood cell transfusions, and prednisone treatment.
Findings:
- This case represents the first reported instance of levofloxacin-induced AIHA.
- While rare, hemolytic anemia has been associated with other fluoroquinolones like ciprofloxacin and temafloxacin.
- The exact mechanism of levofloxacin-induced AIHA remains unclear but is presumed to be immune-mediated.
Implications:
- Levofloxacin-induced AIHA is a rare but potentially fatal adverse drug reaction.
- Discontinuation of levofloxacin and appropriate treatment are vital for managing this condition.
- Caution is advised when prescribing levofloxacin to patients with a history of fluoroquinolone reactions.
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