A Case of Cimetidine-induced Immune Hemolytic Anemia.
- Author:
Ye Rim LEE
1
;
Hee Jin SO
;
Yoon Hwan CHANG
;
Su Yeon CHO
;
Dae Hyun BACK
;
Kyung Ah LIM
;
Jungwon HYUN
;
Kyou Sup HAN
;
Hye Jin KANG
Author Information
1. Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. hyejin@kcch.re.kr
- Publication Type:Case Report
- Keywords:
Hemolytic anemia;
Cimetidine;
Drug-induced
- MeSH:
Acetaminophen;
Anemia, Hemolytic;
Antigen-Antibody Complex;
Blood Pressure;
Cimetidine;
Coma;
Consciousness;
Diazepam;
Emergencies;
Erythrocytes;
Female;
Haptoglobins;
Humans;
Korea;
Lactic Acid;
Lymphoma, B-Cell;
Reticulocytes;
Shock
- From:Korean Journal of Blood Transfusion
2011;22(1):65-69
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
There have been 5 case reports about immune hemolytic anemia related with cimetidine, but there has been no such report in Korea. A sixty-four-year-old woman was admitted to the emergency department in a coma. She was diagnosed with diffuse large B-cell lymphoma 5 years ago and she achieved a complete remission after treatment. She was in a state of shock, and her blood pressure was 70/40 mmHg. The laboratory test results were consistent with hemolytic anemia (HA) as follows: hemoglobin: 1.9 g/dL, corrected reticulocyte count: 2%, total/conjugated bilirubin: 6.4/2.1 mg/dL, lactate dehydrogenase: 1,083 U/L and haptoglobin <10 mg/dL. She had a history of taking the drugs including cimetidine, acetaminophen and etizolam for two days. She urgently received transfusion of 3 units of packed red blood cells and then she regained consciousness. To investigate the relation between cimetidine and HA, we subsequently performed a drug-induced immune complex test and an antibody test by using cimetidine, AB serum and phosphate-buffered saline. The results proved that cimetidine was the cause of the HA. Patient was treated with steroid, and the following laboratory tests showed rapid improvement. This is the first case report from Korea that shows the causal relationship between cimetidine and immune HA.
