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Fatal hemolysis induced by ceftriaxone in a child with sickle cell anemia
J C Bernini1, M M Mustafa, L J Sutor
1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063, USA.
Insights
A child with sickle cell anemia experienced a fatal hemolytic reaction after ceftriaxone. This rare immune response involved IgM antibodies destroying red blood cells.
Area of Science:
- Pediatric Hematology
- Immunology
- Pharmacology
Background:
- Sickle cell anemia is a serious genetic blood disorder.
- Ceftriaxone is a common antibiotic used in pediatric care.
- Drug-induced hemolytic anemia is a rare but severe adverse reaction.
Observation:
- A 2-year-old boy with sickle cell anemia developed a massive hemolytic reaction.
- The reaction occurred shortly after intravenous administration of ceftriaxone.
- The patient presented with hemoglobinuria, indicating red blood cell destruction.
Findings:
- Laboratory studies identified an IgM antibody specific to ceftriaxone.
- This antibody formed immune complexes that bound to and destroyed the patient's erythrocytes.
- The mechanism of red blood cell destruction was confirmed as immune-mediated.
Implications:
- This case highlights a rare but life-threatening complication of ceftriaxone therapy.
- Clinicians should consider ceftriaxone-induced immune hemolytic anemia in the differential diagnosis of hemoglobinuria in children.
- Awareness of this adverse reaction is crucial for prompt diagnosis and management in pediatric patients.
Abstract:
A 2-year-old boy with sickle cell anemia had a massive, fatal hemolytic reaction after administration of an intravenous dose of ceftriaxone. Laboratory studies demonstrated the presence of an IgM antibody against ceftriaxone, binding to and destroying the patient's erythrocytes by an immune complex mechanism. This rare complication should be considered in the differential diagnosis when hemoglobinuria develops in a child after administration of ceftriaxone or a similar agent.