Hemolytic anemia allergic drug reaction

Allergic reactions (e.g., rashes, urticaria, and eosino-philia) have been observed. These drugs have occasionally been associated with cholestatic jaundice, blood dyscrasias, hemolytic anemia, hypoglycemia, and nephrotoxicity. Recently the use of ciprofloxacin for prophylaxis protection against anthrax infection has been associated with damage to muscle ligaments. 

The problems encountered most frequently with sulfonamide drugs include gastrointestinal distress, increased skin sensitivity to ultraviolet light, and allergic reactions. Serious disturbances in the formed blood elements, including blood dyscrasias such as agranulocytosis and hemolytic anemia, may also occur during systemic sulfonamide therapy. 

Blood dyscrasias, mostly dose independent, are among the most important allergic-type adverse reactions to drugs. Aplastic anemia is a serious but rare (presumably) idiosyncratic reaction. It has been reported in association with chloramphenicol, quinacrine, phenylbutazone, mephenytoin, gold compounds, and potassium chlorate. Hemolytic anemia, thrombocytopenia, and agranulocytosis may result from an unusual, acquired sensitivity to a variety of widely used drugs including aminopyrine, phenylbutazone, phenothiazines, propylthiouracil, diphenylhydantoin, penicillins, chloramphenicol, sulfisoxazole, and tolbutamide. 

Neuroleptic drugs infrequently produce allergic reactions. There are no reports of anaphylactic reactions, but various skin reactions, for example rashes, photosensitivity, and dermatitis, can be viewed as delayed forms of hypersensitivity. Jaundice and blood dyscrasias (hemolytic anemia, agranulocytosis) are rare and may be types of allergic reactions. 

Rarely reported hematological reactions to various neuroleptic drugs include agranulocytosis, thrombocytopenic purpura, hemolytic anemia, leukopenia, and eosinophilia. These are thought to represent allergic or hypersensitivity reactions, although this has been questioned in one detailed case report of chlorpromazine-induced agranulocytosis (514). 

Type II, or cytolytic, reactions are mediated by both IgG and IgM antibodies and usually are attributed to their ability to activate the complement systerrr The major target tissues for cytolytic reactions are the cells in the circulatory system. Examples of type II allergic responses include penicillin-inhemolytic anemia, methyldopa-indMced autoimmune hemolytic anemia, quinidine-induced thrombocytopenic purpura, and sulfonamide-induced granulocytopenia. These autoimmune reactions to drugs usually subside within several months after removal of the offending agent. 

Allergic reactions are the most common adverse effect and take the form of rash, photosensitivity, and drug fever. Less common problems are kidney and liver damage, hemolytic anemia, and other blood problems. 

Allergic reactions (exanthemas, photosensitization, pruritus, eosinophilia, fever, reversible leukopenia, and occasionally hemolytic anemia) are described after administration of nalidixic acid and pipemidic acid. Excessive exposure to sunlight and ultraviolet light should be avoided during therapy with these drugs (Baes 1968 Birkett et al, 1969 Ramsay 1973 Brehm and Korting 1970 Louis et al. 1973 Burry 1974 Ramsay and Obreskova 1974 Boisvert and Barbeau 1981). 

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