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Ceftriaxone causes drug-induced immune thrombocytopenia and hemolytic anemia: characterization of targets on platelets and red blood cells.
- Source :
-
Transfusion . Jul2004, Vol. 44 Issue 7, p1033-1040. 8p. - Publication Year :
- 2004
-
Abstract
- Ceftriaxone, a third-generation cephalosporin, has been reported to occasionally cause fatal drug-induced immune hemolytic anemia (DIHA). A clinical and serologic analysis of the first two patients with severe drug-induced thrombocytopenia (DITP) due to ceftriaxone and one patient with fatal DIHA is reported. Sera were assessed by the IAT, EIA, glycoprotein (GP)-specific immunoassay, flow cytometry, and immunoprecipitation using trans-fectants expressing GPIIb/IIIa and GPIb/IX and with different cephalosporins. Sera from Patients 1 and 2 reacted strongly with PLTs in the presence of the drug, but not with RBCs. The binding sites of the drug-dependent antibodies (DDAbs) could be localized to GPIIb/IIIa and GPIb/IX, respectively. Inhibition studies indicated that DDAbs recognized epitopes residing on the GPIIb/IIIa complex and on the GPIX subunit, respectively. No cross-reactivity was observed with other cephalosporin derivatives. Serum 3 showed strong agglutination with RBCs of Rhnull phenotype in the presence of ex-vivo metabolites of ceftriaxone, but no cross-reactivity with PLTs. The first two cases of severe DITP and a third patient with DIHA are reported. DDAbs from all patients showed individual reaction patterns and clear cell lineage specificity. In addition, the DDAbs were dependent on the substitution at position 3 of the ceftriaxone molecule. Epitopes on GPIIb/IIIa and GPIX were involved on PLTs. The Rh protein was not the only target of DDAbs on RBCs. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00411132
- Volume :
- 44
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Transfusion
- Publication Type :
- Academic Journal
- Accession number :
- 13506496
- Full Text :
- https://doi.org/10.1111/j.1537-2995.2004.03378.x