Immune hemolytic anemia associated with drug therapy.
TL;DR: The most common drugs to cause DIIHA are anti-microbials, which are associated with drug-dependent antibodies, and the most common drug to cause AIHA is fludarabine.
About: This article is published in Blood Reviews.The article was published on 2010-07-01. It has received 186 citations till now. The article focuses on the topics: Immune Hemolytic Anemia & Autoimmune hemolytic anemia.
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TL;DR: The sequelae of DRESS can be divided into 2 major types that appear to occur in different age groups: young patients tend to develop autoimmune diseases, whereas elderly patients are more vulnerable to end-organ failure.
Abstract: Background The development of autoimmune sequelae is one of the characteristic features of drug reaction with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity syndrome; however, the incidence of sequelae and prognosis of patients with DRESS are unknown. Objective We sought to investigate the incidence of sequelae, including less well-known sequelae, and long-term prognosis in patients with DRESS/drug-induced hypersensitivity syndrome. Methods A retrospective cohort study was conducted at a medical center in northern Taiwan using a DRESS/drug-induced hypersensitivity syndrome database. Patients who were followed up for at least 1 year were included in the study. Results Nine patients died before interview, whereas 43 patients completed a specially designed questionnaire. The overall cumulative incidence of long-term sequelae was 11.5% (6 of 52 patients). Four patients developed autoimmune diseases, specifically Graves disease (n = 2), type 1 diabetes mellitus (n = 1), and autoimmune hemolytic anemia (n = 1). Alopecia areata was also noted in 1 of the 2 patients with Graves disease. The other 2 patients developed renal failure after visceral involvement and required lifetime hemodialysis. Limitations Our study included a small number of patients. Further, viral studies were not performed. Conclusion The sequelae of DRESS can be divided into 2 major types that appear to occur in different age groups: young patients tend to develop autoimmune diseases, whereas elderly patients are more vulnerable to end-organ failure.
139 citations
TL;DR: In this article, the authors classified AIHA into warm, mixed or cold-reactive subtypes based on the optimal autoantibody-RBC reactivity temperatures and further subcategorized into idiopathic and secondary with the later being associated with a number of underlying infectious, neoplastic and autoimmune disorders.
100 citations
TL;DR: Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity, however, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment.
Abstract: Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe. Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment and clinical outcome were recorded on a standardized form and mortality, parasite clearance times and the occurrence of adverse events were evaluated. Of the 68 treated patients, including 55 with severe malaria, two patients died (2/55 = 3.6%). The mean time to 50% parasite clearance (PCT50), 90% and 99% were 4.4 hours (3.9 - 5.2), 14.8 hours (13.0 - 17.2), and 29.5 hours (25.9 - 34.4) respectively. Artesunate was well tolerated. However, an unusual form of haemolytic anaemia was observed in seven patients. The relationship with artesunate remains uncertain. Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity. However, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment. Treatment of IV artesunate should be limited to the period that IV treatment is required and should be followed by a full oral course of an appropriate anti-malarial drug.
94 citations
Cites background from "Immune hemolytic anemia associated ..."
...Drug induced haemolysis with a negative direct Coombs test has also been documented [19]....
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TL;DR: DIIHA is often poorly investigated and many reports do not provide data to support the diagnosis, so it is important to exclude DIIHA in such patients as the only treatment needed is to discontinue the drug.
Abstract: Introduction: Drug-induced immune hemolytic anemia (DIIHA) is a rare cytopenia; about 130 drugs have been incriminated The antibodies causing DIIHA can be i) drug-independent (drug not needed to be present to detect antibodies in vitro)—DIIHA caused by this type of antibody presents clinically and serologically as an autoimmune hemolytic anemia (AIHA) with red cell (RBC) autoantibodies in patients' sera and in eluates from their RBCs; or (2) drug-dependent (antibodies react in vitro with RBCs only in the presence of drug, on the RBC membrane or when added to the patient's plasma and RBCs) Areas covered: Literature is reviewed regarding pathophysiology of DIIHA (mechanisms; incidence of drugs involved; the clinical, hematological, and serological characteristics of the most common antibodies causing DIIHA) Expert opinion: DIIHA is often poorly investigated and many reports do not provide data to support the diagnosis (ie, no serology to support an immune etiology) The three most common drugs currentl
92 citations
TL;DR: Although recommendations are unchanged, an expanded version of this guideline is available as Appendix S2, and the Grading of Recommendations Assessment, Development and Evaluation nomenclature was used to evaluate levels of evidence and to assess the strength of recommendations.
Abstract: Literature review details. Recommendations are based on the systematic review of published English language literature from January 1960 to October 2015 (see Appendix S1 for further details). Although recommendations are unchanged, an expanded version of this guideline is available as Appendix S2. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate levels of evidence and to assess the strength of recommendations. The GRADE criteria are specified in the British Committee for Standards in Haematology (BCSH) guidance pack (http://www.bcshguidances.com/BCSH_PRO CESS/42_EVIDENCE_LEVELS_AND_GRADES_OF_RECOM MENDATION.html) and the GRADE working group website (http://www.gradeworkinggroup.org.
89 citations
Cites background from "Immune hemolytic anemia associated ..."
...In the series reported by Garratty (2010), 36 cases (43...
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...Fatality rates of 6-15% have been reported with cephalosporins and diclofenac (Ahrens et al, 2006; Garratty, 2010)....
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...Drug-induced immune haemolytic anaemia The incidence of DIIHA is approximately 1 per million/year (Garratty, 2010)....
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...The DAT is almost always positive for IgG and/or C3 (unless massive intravascular haemolysis has occurred or red cell transfusion has been given prior to testing) (Garratty, 2010)....
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...The incidence of DIIHA is approximately 1 per million/year (Garratty, 2010)....
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References
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Book•
01 Jan 1963
TL;DR: The anatomical basis of the immune system architecture of immunity induction and regulation of immune responses and advances in technology immunological intervention allergy connective tissue disease immunodeficiency are discussed.
Abstract: Volume 1: anatomical basis of the immune system architecture of immunity induction and regulation of immune responses. Volume 2: advances in technology immunological intervention allergy connective tissue disease immunodeficiency. Volume 3: immunology of infection transplantation tumour immunology organ-based immunology.
1,326 citations
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TL;DR: This little book brings within the reach of workers in immunology almost a fabulous wealth of references in an exceptionally small compass.
Abstract: This little book brings within the reach of workers in immunology almost a fabulous wealth of references in an exceptionally small compass. The references are indicated, generally, serially by small numerals, expanded in footnotes and given at length at the end of each section. By this plan the narrative has been made continuous and concise. For 146 pages of subject-matter there are no less than 1,197 references. After a short introduction to ' elementary concepts and phenomena of serology' for the benefit of the beginner, the subject has been critically reviewed under five headings: (1) The Serological Specificity of Proteins, (2) The Specificity of Cell Antigen, (3) The Specificity of Antibodies, (4) Artificial Conjugated Antigen, (5) Specific Carbohydrates and Lipoids. That the review will serve its intended purpose of assisting work in immunology admits of no doubt. That the short introduction will inspire beginners may be doubted.
1,148 citations
TL;DR: Evidence is presented that T cells can exert specific feedback control of autoantibody formation and relaxation of T-cell control in ageing humans and experimental animals may be an important contributory factor in the development of autoimmunity.
448 citations
409 citations
"Immune hemolytic anemia associated ..." refers background in this paper
...The first generation cephalosporins (cephalothin, cephalexin, and cefazolin) caused positive DATs but rarely caused DIIHA....
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...One can also show that IgG penicillin antibodies will bind to these drug-coated RBCs in vitro and in vivo and that such IgG-coated RBCs can interact with Fc receptors on macrophages, sometimes leading to extravascular immune destruction in a similar way as in AIHA....
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...There are good data for the incidence of drug-induced thrombocytopenia (10–18 cases per million)10,11 and neutropenia (2–15 cases per million),12 but only crude estimates for DIIHA....
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...Table 4 shows the characteristics of cefotetan-induced DIIHA....
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..., methyldopa) could cause the production of true RBC autoantibodies,(31) and these could sometimes cause AIHA.(32) This added a third possible mechanism for drug-induced positive DATs and sometimes IHA....
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