Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure

Ceftizoxime 투약 후 면역용혈빈혈 및 다발장기부전

  • Huh, Jin-Young (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Ari (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hyungsuk (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwon, Seog-Woon (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • An, Sujong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jae Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwon, Byoung Soo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Eun Hye (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Do Hyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Huh, Jin Won (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 허진영 (울산대학교 의과대학 서울아산병원 내과) ;
  • 안아리 (울산대학교 의과대학 서울아산병원 진단검사의학과) ;
  • 김형석 (울산대학교 의과대학 서울아산병원 진단검사의학과) ;
  • 권석운 (울산대학교 의과대학 서울아산병원 진단검사의학과) ;
  • 안수종 (울산대학교 의과대학 서울아산병원 내과) ;
  • 이재용 (울산대학교 의과대학 서울아산병원 내과) ;
  • 권병수 (울산대학교 의과대학 서울아산병원 내과) ;
  • 오은혜 (울산대학교 의과대학 서울아산병원 내과) ;
  • 박도현 (울산대학교 의과대학 서울아산병원 내과) ;
  • 허진원 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2016.05.02
  • Accepted : 2016.08.11
  • Published : 2017.06.30
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Abstract

Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure - shortly after the infusion of ceftizoxime - the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

Keywords

References

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