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Related Experiment Videos

Sulindac-induced immune hemolytic anemia

M L Angeles1, M E Reid, U A Yacob

  • 1Immunohematology Laboratory, New York Blood Center, North Shore University Hospital at Glen Cove, New York.

Transfusion
|March 1, 1994
PubMed
Summary

Sulindac, a nonsteroidal anti-inflammatory drug, can cause severe immune hemolytic anemia. This case highlights the drug-induced immune hemolytic anemia (DIIHA) risk, emphasizing the need for physician awareness.

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Area of Science:

  • Hematology
  • Immunology
  • Pharmacology

Background:

  • Sulindac, an indene-derived nonsteroidal anti-inflammatory drug (NSAID), is associated with adverse drug reactions.
  • Immune hemolytic anemia (IHA) is a rare but serious complication of certain medications.

Observation:

  • A patient developed life-threatening immune hemolytic anemia, kidney, and liver failure after sulindac ingestion.
  • Laboratory tests revealed a sulindac-dependent antibody (IgG and IgM) in the patient's serum.
  • The antibody showed specific reactivity with human and chimpanzee red blood cells.

Findings:

  • The direct antiglobulin test was positive for IgG, and the eluate reacted with sulindac.
  • The sulindac-dependent antibody agglutinated red blood cells from humans and chimpanzees, suggesting a specific red cell component is involved.

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  • Red blood cells treated with enzymes like trypsin and papain still reacted with the antibody.

    • Implications:

    • The findings support the immune complex mechanism in drug-induced immune hemolytic anemia.
    • Physicians should be aware of the potential severity of sulindac-induced hemolytic anemia.
    • Early recognition and intervention are crucial for managing this adverse drug reaction.