Massive haemolysis after intramuscular diclofenac in a patient who apparently tolerated oral medication
| Autor: | Edeltraut Garbe, Abdulgabar Salama, L. Schewior, Holger Kiesewetter, Norbert Ahrens |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Anemia
Hemolytic medicine.medical_specialty Diclofenac Nausea 610 Medizin Administration Oral Injections Intramuscular Gastroenterology Antibodies Diagnosis Differential Oral administration Internal medicine medicine Humans Renal Insufficiency Aged business.industry diclofenac drug-dependent antibodies drug-induced haemolysis immunehaemolytic anaemia Autoantibody Hematology General Medicine Jaundice Haemolysis Surgery stomatognathic diseases Prednisolone Female Anemia Hemolytic Autoimmune medicine.symptom Intramuscular injection business medicine.drug |
| Zdroj: | Vox Sanguinis. 86:71-74 |
| ISSN: | 1423-0410 0042-9007 |
| DOI: | 10.1111/j.0042-9007.2004.00389.x |
| Popis: | Background and Objectives Administration of diclofenac may lead to immune haemolytic anaemia (IHA) owing to the presence of drug-dependent antibodies and/or autoantibodies. A relationship with oral or intramuscular drug administration is unknown. Here, we describe a patient who apparently tolerated oral diclofenac but developed severe IHA following intramuscular injection of the drug. Patients and Methods A 66-year-old-female was admitted to hospital because of jaundice and nausea, which were initially presumed to be manifestations of a postcholecystectomy syndrome. The patient soon developed haemolysis and renal failure. Although the symptoms and signs were suggestive of autoimmune haemolytic anaemia (AIHA), the patient had diclofenac-induced IHA. Results Serological testing, including detection of drug-dependent antibodies, was performed using standard techniques. The patient's serum was found to contain a highly reactive diclofenac-dependent red cell antibody of the immune complex type (titre 256 000). She recovered after 7 weeks of treatment with prednisolone, blood transfusions, haemodialysis and plasma exchange. Conclusions Diclofenac-induced IHA should always be considered when a patient on diclofenac develops haemolysis. |
| Databáze: | OpenAIRE |
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