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Drug-Induced Autoimmune Hemolytic Anemia

AHA


Presentation

  • Clinical description The disease presents with anemia linked to hemolysis, and physical examination may show an enlarged spleen.[orpha.net]
  • Case Report A 24-year-old Ethiopian female, previously healthy, presented to our Accident and Emergency Department with fatigue, intermittent fever and abdominal pain lasting 1-month.[jahjournal.org]
Sputum
  • The sputum culture for acid-fast bacilli, which was sent on last admission, came positive for mycobacterial TB sensitive to all anti-TB medications, confirming our clinical suspicion.[jahjournal.org]
Productive Cough
  • Also, she had a productive cough of yellowish sputum, but no hemoptysis. There was a history of anorexia and weight loss of 8 kg. She denied any history of drug use, contact with TB patients or recent travel.[jahjournal.org]
Neuralgia
  • Diseases and Disorders section features more than 300 new figures and tables, as well as 20 new topics including: cyclic vomiting syndrome, traveler’s diarrhea, chronic pruritus, post-herpetic neuralgia, enteropathic arthritis, and hoarding disorder.[books.google.com]
Meningism
  • However, treatment with corticosteroids improved survival for the patient with bacterial meningitis, tuberculous meningitis, tuberculous pericarditis and are considered beneficial and safe for a wide variety of infections, while on the appropriate antibiotic[jahjournal.org]

Workup

  • Hemolytic Anemia Workup. Medscape Reference. Available online at . Accessed October 2015. (March 21, 2014) National Heart, Lung and Blood Institute. Types of Hemolytic Anemia. Available online at . Accessed October 2015.[labtestsonline.it]
  • In the workup of HA, a careful drug history must be taken, and if suspected, a search for drug-induced antibodies should be made by a reference laboratory with expertise in this area. A U.S.[hematologyandoncology.net]
  • A serological workup to investigate the presence of RBC alloantibodies includes testing the patient’s serum with a selected panel of previously phenotyped reagent RBCs.[dovepress.com]
Bicytopenia
  • Autoimmune bicytopenia in pulmonary tuberculosis. Report of a pediatric case. Respir Med CME 2008;1:281-3. 9. Safe IP, O'brien C, Ferreira FR, Souza ML, Ramasawmy R.[jahjournal.org]

Treatment

  • However, steroid therapy is an option when hemolysis fails to respond to anti-TB treatment.[jahjournal.org]
  • The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]
  • Ferri’s Clinical Advisor 2018 is the most efficient, intuitive, and thorough resource of its kind, trusted by physicians to provide current diagnosis and treatment recommendations for hundreds of common medical conditions.[books.google.com]

Prognosis

  • Prognosis The prognosis is good if the causative drug is identified and the patient stops taking it. Death is a rare outcome, but has been reported particularly in children with AIHA caused by cefotetan and ceftriaxone.[orpha.net]
  • , Prevention, and Complications Prognosis mortality rate 10% for most patients, prognosis is good Prevention for cold agglutinin disease keep warm Complications warm agglutinin lymphoproliferative disease venous thromboembolism cold agglutinin peripheral[medbullets.com]
  • […] dermatomyositis, myasthenia gravis, pemphigus, pemphigoid, membranous glomerulonephritis, autoimmune hepatitis, autoimmune thyroiditis, autoimmune haemolytic anaemia, Sjögren’s syndrome, and scleroderma.” 1 Conclusion Although DILE has a more favorable prognosis[pharmacytimes.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • Etiology To date about 100 drugs have been implicated in drug-induced AIHA, including: cephalosporins (primarily cefotetan and ceftriaxone), levodopa, methyldopa, penicillin and its derivatives, quinidine and some nonsteroidal anti-inflammatory drugs.[orpha.net]

Epidemiology

  • Summary Epidemiology Drug-induced AIHA is rare; annual incidence is estimated at about 1/1,000,000. It is more common in adults and is very rare in children, although some fatal cases in children have been reported.[orpha.net]
  • Introduction Extrinsic hemolytic anemia caused by antibodies type II hypersensitivity Epidemiology peak incidence in 50s-80s Presentation Symptoms warm agglutinin disease chronic hemolytic anemia cold agglutinin disease acrocyanosis (different from Raynaud[medbullets.com]
  • […] cold hemoglobinuria (PCH) Mixed AIHA (antibodies bind from 4 C to 37 C): a range of autoantibody thermal amplitudes that has features of both warm and cold AIHA Drug-induced AIHA: related to drug exposure; similar to warm AIHA and mainly IgG mediated Epidemiology[unboundmedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • Etiology and Pathophysiology Mechanisms of RBC destruction ( 1, 2, 3 ) IgG, IgM, or IgA isotypes target RBC antigens, causing either direct opsonization and/or triggering of complement fixation.[unboundmedicine.com]
  • Pharmacotherapy: A Pathophysiologic Approach. 7th ed. United States: The McGraw-Hill Companies, Inc; 2008: 1439-1440. Borchers AT, Keen CL, Gershwin ME. Drug-induced lupus. Ann N Y Acad Sci 2007 Jun; 1108; 166-82.[pharmacytimes.com]
  • Pathophysiology and Primary AIHA In AIHA the hemolysis is mainly extravascular, with sequestration mainly occurring in the liver and the spleen.[pedclerk.bsd.uchicago.edu]
  • Cases of AIHA have also been classified by the presence or absence of various pathophysiologically associated underlying conditions.[dovepress.com]
  • Pathophysiology There are two mechanisms of hemolysis. Intravascular hemolysis is the destruction of red blood cells in the circulation with the release of cell contents into the plasma.[aafp.org]

Prevention

  • Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% Health Topic[codelay.com]
  • Now in its second edition, this popular and essential comprehensive resource provides a detailed analysis of how to identify, prevent, and manage drug-induced diseases. Edited by James E. Tisdale and Douglas A.[books.google.com]
  • (ChemotherapyAdvisor) – Several studies demonstrate the role of aspirin in cancer prevention, according to the authors of a recently published review article.[cancertherapyadvisor.com]
  • , and Complications Prognosis mortality rate 10% for most patients, prognosis is good Prevention for cold agglutinin disease keep warm Complications warm agglutinin lymphoproliferative disease venous thromboembolism cold agglutinin peripheral gangrene[medbullets.com]
  • Haemolytic Disease of the Newborn - #2 Can cause severe anaemia in foetus, with erythroblastosis and heart failure Hyperbilirubinaemia can lead to severe brain damage (kernicterus) if not promptly treated HDN due to Rh incompatibility can be almost totally prevented[slideshare.net]

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