Mefenamic acid hemolytic anemia with

Mefenamic acid [meh FEN a mick] and meclofenamate [meh KLO fen a mate] have no advantages over the other NSAIDs as antiinflammatory agents. Their side effects, such as diarrhea, can be severe and associated with inflammation of the bowel. Cases of hemolytic anemia have been reported. 

Hemolytic anemia has occasionally been associated with NSAIDs many reports involved mefenamic acid, ibuprofen and sulindac (54). No evidence has been found that any NSAID, except aspirin, constitutes a particular risk for subjects with glucose-6-phosphate dehydrogenase deficiency. 

Overall, however, the reason that only some patients develop autoantibodies, and that only some of those have hemolytic disease, is not known. In an effort to explain why patients may have a positive result from a Coombs test and no hemolysis, Kelton demonstrated that methyldopa impairs the abihty of these patients to remove antibody-sensitized cells. In Coombs-positive patients receiving methyldopa, patients with impairment of the reticuloendothelial system could not clear the RBCs coated with autoantibodies from their bloodstream, and therefore hemolysis did not occur. Patients with hemolysis had no impairment of the reticuloendothelial system. Procainamide has also been reported to cause a positive result on the direct anti-human globulin test and hemolytic anemia. Other drugs that have been reported to cause autoimmune hemolytic anemia include levodopa, mefenamic acid, and diclofenac. ... 

Some other drugs produce an autoimmune hemolytic anemia in which the antibodies are directed towards native antigens on the red cell surface, while the drug does not seem to function as a hapten in the reaction. This type of autoimmune hemolytic anemia has been described following treatment with levodopa, methyl-dopa, and mefenamic acid (Worrledge et al. 1966 Worrledge 1973). With a-methyldopa, clinically significant hemolysis develops in less than 1 % of individuals... 

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See also in sourсe #XX -- [ ]

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