Anemia drug-induced

Autoimmune chronic active hepatitis Autoimmune hemolytic anemia, drug-induced SLE, myasthenia gravis, pemphigus, glomerulonephritis, Goodpasture s disease... 

Examples of type II cytotoxic antibody-mediated drug reactions include drug-induced immune hemolytic anemia, drug-induced thrombocytopenia where a number of different mechanisms are involved and acute agranulocytosis in which more than 70 % of cases are caused by drugs... 

Rare cases of hemolytic anemia, including fatalities, have been reported with the administration of the cephalosporins. The patient should be monitored for anemia If a patient experiences anemia within 2 to 3 weeks after the start of cephalosporin therapy, drug-induced anemia should be considered. If hemolytic anemia is suspected, the primary health care provider will discontinue the drug therapy. The patient may require blood transfusions to correct tire anemia. Frequent hematological studies may be required. 

In contrast to a-methyldopa-induced hemolytic anemia, most drug-induced hemolytic anemia, especially for penicillins [34] and cephalosporins [35], involves drug-dependent antibodies, presumably because the drug acts as a hapten to directly modify erythrocytes or form immune complexes [36], However, there are many examples where a drug, such as nomifensine, induces both drug- (or metabolite)-dependent and drug-... 

Bll. Beutler, E., Drug-induced hemolytic anemia (Primaquine sensitivity). In The Metabolic Basis of Inherited Disease (J. B. Stanbury, J. B. Wyngaarden, and D. S. Fredrickson, eds.), pp, 1031-1067. McGraw-Hill, New York, 1960. 

G19. Gross, R. T., and Marks, P. A., An hereditary enzymatic defect in red blood cells Its relation to certain drug induced hemolytic anemias. Ann. N.Y. Acad. Sci. 75, 100-109 (1958). 

Szeinberg, A., Sheba, C., Hirshom, N., and Bodonyi, E., Studies on erythrocytes in cases with past history of favism and drug induced hemolytic anemia. Blood 12, 603-613 (1957). 

Antibiotics Isoniazid Penicillins Hypersensitivity and Autoimmunity Rash, dermatitis, vasculitis, arthritis, drug-induced SLE Anaphylaxis, dermatitis vasculitis, serum sickness, hemolytic anemia... 

Sulfonamides Dermatitis, photosensitivity pemphigus, hemolytic anemia, serum sickness, drug-induced SLE... 

Finally, the successful use of vincristine in the treatment of drug-induced microangiopathic hemolytic anemia, a disease resembling the hemolytic uremic syndrome rarely seen subsequent to administration of mitomycin C or other chemotherapy has been described in two patients with this disorder (79). 

The last potential mechanism to be discussed in this chapter is drug-induced altered receptor expression. Hematopoiesis is a very intricate process that is regulated by cytokines and cell-cell interactions. Interruption with any of these processes can result in hematotoxicity. For example, zidovudine (AZT) decreases Epo [27], GM-CSFaand to lesser extent IL-3 receptor expression [7]. Decrease in the expression of the above receptors seems to lead to anemia and neutropenia, by decreasing the number of CFU-E and CFU-GM, respectively. 

Contraindications Impaired renal orhepaticfunction, history of drug-induced hemolytic anemias or other anemias, history of hypersensitivity to metaxalone... 

Approximately 30% of patients using sulfasalazine discontinue the drug because of toxicity. Common adverse effects include nausea, vomiting, headache, and rash. Hemolytic anemia and methemoglobinemia also occur, but rarely. Neutropenia occurs in 1-5% of patients, while thrombocytopenia is very rare. Pulmonary toxicity and positive double-stranded DNA are occasionally seen, but drug-induced lupus is rare. Reversible infertility occurs in men, but sulfasalazine does not affect fertility in women. The drug does not appear to be teratogenic. 

The side effects of mycophenolate mofetil include diarrhea, abdominal pain, constipation, nausea/vomiting, acne, dyspnea, cough, peripheral edema, increased risk of infections, drug-induced fever, dizziness, headaches, leukopenia and anemia. 

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