病例报告:一种严重的药物诱导的免疫血液溶解性贫血是由万科米所引起的
Yangyi Xie1, Zhongying Wang2, Danfei Deng1
1Department of Blood Transfusion, Ningbo No.2 Hospital, Ningbo, China.
Frontiers in medicine
|December 8, 2025
概括
药物诱导的免疫血液溶解性贫血 (DIIHA) 可能危及生命. 这一案例强调了万科米辛是DIIHA的原因,强调了通过对患有不明原因贫血的患者进行抗体测试的快速诊断.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 药物诱导的免疫血液溶解性贫血 (DIIHA) 是一种严重的药物不良反应.
- 导致DIIHA的药物范围正在扩大,需要临床警.
- 范科米辛是一种抗生素,可能会诱导DIIHA.
研究的目的:
- 报告中国一名患者的万科米辛诱导血液溶解病例.
- 为了强调在临床实践中考虑DIIHA的重要性.
主要方法:
- 一个50岁的男性患者的案例研究,在万科米辛治疗后患有溶血性贫血.
- 血清检测检测菌素特异性抗体 (主要是IgG).
- 对临床表现的分析,包括血红蛋白水平,胆红素,LDH和尿液血红蛋白.
主要成果:
- 患者在术后第8天出现严重的溶血性贫血.
- 实验室发现包括血红蛋白降低,间接胆红素和LDH升高,以及血红素尿.
- 确定了高滴度的米辛特异性IgG抗体,具有针对N抗原的特异性.
结论:
- 范科米辛可以引起药物诱导的免疫血液溶解性贫血.
- 在新药暴露后患有不明原因贫血的患者中,早期考虑DIIHA至关重要.
- 对药物依赖性抗体的血清测试对于诊断DIIHA至关重要.
相关概念视频
Immunodeficiency Diseases
3.7K
Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency...
There are three main causes of immunodeficiency...
3.7K
Pulmonary Tuberculosis I
1.7K
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
1.7K
Drug Toxicity: Risk factors
229
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
229
Drug Toxicity: Allergic Reactions
209
Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
209
Hypersensitivity Reactions: Cytolytic Reactions
208
Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...
208
Drug toxicity: Idiosyncratic Reactions
220
Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
220
