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Tolbutamide-induced hemolytic anemia

P Malacarne, G Castaldi, M Bertusi

    Diabetes
    |February 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    A diabetic patient developed hemolytic anemia due to tolbutamide. An IgG antibody caused red blood cell agglutination with tolbutamide-coated cells, indicating a drug-induced immune reaction.

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    Area of Science:

    • Immunology
    • Hematology
    • Pharmacology

    Background:

    • Drug-induced hemolytic anemia is a rare but serious adverse effect of certain medications.
    • Tolbutamide, an oral hypoglycemic agent, has been implicated in immune-mediated adverse drug reactions.

    Observation:

    • A 67-year-old female diabetic patient on long-term tolbutamide treatment presented with Coombs'-positive hemolytic anemia.
    • Patient's serum contained an IgG antibody responsible for red blood cell agglutination.

    Findings:

    • The identified IgG antibody caused agglutination of autologous red blood cells when coated with tolbutamide, independent of complement activation.
    • The antibody also cross-reacted with erythrocytes treated with other sulfonylureas, but not with phenacetin.

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    Implications:

    • This case highlights a specific immune mechanism for tolbutamide-induced hemolytic anemia.
    • The findings suggest potential cross-reactivity with other sulfonylurea drugs, necessitating careful patient monitoring.