Trimethoprim‐induced immune hemolytic anemia in a pediatric oncology patient presenting as an acute hemolytic transfusion reaction |
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| Authors: | Sweta Gupta MBBS MD Cindy L. Piefer MT SBB Judy T. Fueger MT SBB Susan T. Johnson MSTM MT SBB Rowena C. Punzalan MD |
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| Affiliation: | 1. Department of Pediatrics (Hematology/Oncology), Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin;2. Immunohematology Reference Laboratory, Blood Center of Wisconsin, Milwaukee, Wisconsin;3. Blood Center of Wisconsin, Milwaukee, Wisconsin |
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| Abstract: | A 10‐year‐old male with acute leukemia presented with post‐chemotherapy anemia. During red cell transfusion, he developed hemoglobinuria. Transfusion reaction workup was negative. Drug‐induced immune hemolytic anemia was suspected because of positive direct antiglobulin test, negative eluate, and microspherocytes on smear pre‐ and post‐transfusion. Drug studies using the indirect antiglobulin test were strongly positive with trimethoprim and trimethoprim–sulfamethoxazole but negative with sulfamethoxazole. The patient recovered after discontinuing the drug, with no recurrence in 2 years. Other causes of anemia should be considered in patients with worse‐than‐expected anemia after chemotherapy. Furthermore, hemolysis during transfusion is not always a transfusion reaction. Pediatr Blood Cancer. 2010;55:1201–1203. © 2010 Wiley‐Liss, Inc. |
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| Keywords: | drug‐induced immune hemolytic anemia leukemia trimethoprim |
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