Immune hemolytic anemia

Immune hemolytic anemia Immune hemolytic anemia has been observed in patients receiving cephalosporin class antibiotics. 

In addition to cancer, too little apoptosis can also result in diseases such as autoimmune lymphoproliferative syndrome (ALPS). This occurs when there is insufficient apoptosis of auto-aggressive T cells, resulting in multiple autoimmune diseases. An overproliferation of B cells occurs as well, resulting in excess immunoglobulin production, leading to autoimmunity. Some of the common diseases of ALPS include hemolytic anemia, immune-mediated thrombocytopenia, and autoimmune neutropenia. The different types of this condition are caused by different mutations. Type 1A results from a mutation in the death domain of the Fas receptor, Type IB results from a mutation in Fas ligand, and Type 2 results from a mutation in caspase 10, reducing its activity. 

Congenital hemolytic anemia Immune deficiency Pregnancy... 

Aplastic anemias (some forms) Complications of malignancy Hypercalcemia Hematologic malignancies Acute lymphoblastic leukemia Lymphomas Multiple myeloma Immune hemolytic anemia Immune thrombocytopenia Inflammatory bowel disease Transfusion reactions Allergic and Immune Diseases Acute hypersensitivity reactions Allergic rhinitis Anaphylaxis... 

The answer is a. (Katzung, p 162.) Many drugs can cause an immunohemolytic anemia. Methyldopa may cause a positive Coombs test in as many as 20% of patients, along with hemolytic anemia. Other drugs with similar actions on red blood cells are penicillins, quinidine, procainamide, and sulfonamides. These form a stable or unstable hapten on the red cell surface, which induces an immune reaction I immunoglobulin G (IgG) antibodies] and leads to dissolution of the membrane. 

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-... 

Arndt, P.A., Leger, R.M., and Garratty, G., Serology of antibodies to second- and third-generation cephalosporins associated with immune hemolytic anemia and/or positive direct antiglobulin tests, Transfusion, 39, 1239, 1999. 

Salama, A. and Mueller-Eckhardt, C., Rh blood group-specific antibodies in immune hemolytic anemia induced by nomifensine, Blood, 68,1285, 1986. 

Kleinman, S., Nelson, R., Smith, L. and Goldfinger, D. (1984). Positive direct antiglobulin tests and immune hemolytic anemia in patients receiving procainamide. New Engl. J. Med. 311 809-812. 

Zaja, R, lacona, L, Masolini, P, Russo, D., Sperotto, A., Prosdocimo, S., Patriarca, R, de Vita, S., Regazzi, M., Baccarani, M., and Panin, R., B-cell depletion with rituximab as treatment for immune hemolytic anemia and chronic thrombocytopenia, Haematologica, 87, 189-195, 2002. 

Adverse effects. Fatigue, orthostatic hypotension, extrapyramidal Parkin-son-like symptoms (p. 88), cutaneous reactions, hepatic damage, immune-hemolytic anemia... 

Pneumococcal Vaccine, Polyvalent (Pneumovox-23) [Vaccine/ Inactive Bacteria] Uses Immunization against pneumococcal Infxns in pts at high risk (eg, all = 65 y of age) Action Active immunization Dose 0.5 mL EM. Caution [C, ] Contra Do not vaccinate during immunosuppressive thCTapy Disp Inj SE Fever, inj site Rxn, hemolytic anemia, thromboc5rtopenia, anaphylaxis Interactions Effects W/ corticosteroids, immunosuppressants EMS None OD ... 

Immunoglobulin obtained from pooled plasma obtained from hepatitis B and HIV negative donors is used as an aspecific immunostimulant in immunodeficiency diseases, idiopathic thrombocytopenia, autoimmune hemolytic anemias, Kawasaki syndrome and to prevent infections in immune compromised patients with leukemia or multiple myeloma. Adverse effects include potentially severe hypersensitivity reactions. 

Immune globulin, given intramuscularly or intravenously, is recommended in the treatment of primary humoral immunodeficiency, congenital agammaglobulinemias, common variable immunodeficiency, severe combined immunodeficiency, idiopathic thrombocytopenic purpura, and autoimmune hemolytic anemia. There are six licensed preparations of immune globulin. 

A) Yes. The mother should receive Rho(D) immune globulin to prevent hemolytic anemia in future neonates. 

L A. An Rh-negative mother can develop antibodies against the Rh antigen if she is exposed to the blood of an Rh-positive baby during pregnancy or birth. If no therapy is given, hemolytic anemia can occur in future Rh-positive babies. Rho(D) immune... 

IgG or IgM antibodies direct the immune response toward the antigen located on a cell (e.g., a red blood cell or thrombocyte). Macrophages, NK cells, and neutrophils are recruited by the antibodies to the site of the antigen on the cell surface and destroy the cell by phagocytosis or lysis. Additionally, complement activation will damage the cell (Fig. 6.32). The result, for example, where red cells are the targets is hemolytic anemia. 

The newer derivatives seem less likely to cause hypersensitivity reactions, perhaps because the protein adducts generated are shorter lived. All four types of hypersensitivity reaction have been observed with penicillin. Thus, high doses may cause hemolytic anemia and immune complex disease and cell-mediated immunity may give rise to skin rashes and eruptions, and the most common reactions are urticaria, skin eruptions, and arthralgia. Antipenicillin IgE antibodies have been detected consistently with an anaphylactic reaction. The anaphylactic reactions (type 1 see above), which occur in 0.004% to 0.015% of patients, may be life threatening. 

Azathioprine is an effective agent in suppressing the immune system in patients undergoing renal transplantation and in patients suffering from acute glomerulonephritis, the renal component of systemic lupus erythematosus, prednisone-resistant idiopathic thrombocytopenic purpura, and functioning autoimmune hemolytic anemia. Azathioprine depresses bone marrow functioning, which is its chief side effect. 

Mackey, M., Periodic auto-immune hemolytic anemia An induced dynamical disease, Bulletin of Mathematical Biology, Vol. 41, No. 6, 1979, pp. 829-834. 

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