The diagnosis and testing of immune hemolytic anemia induced by ceftizoxime sodium drug-dependent antibodies
10.13303/j.cjbt.issn.1004-549x.2025.09.017
- VernacularTitle:头孢唑肟钠药物抗体致免疫性溶血性贫血的诊断与检测
- Author:
Jing WANG
1
;
Yangyi XIE
2
;
Sha JIN
3
;
Wei SHEN
3
;
Dong XIANG
3
;
Zhongying WANG
3
Author Information
1. Shanghai Blood Center, Shanghai 200051, China; Department of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
2. Department of Blood Transfusion, Ningbo No. 2 Hospital, Ningbo 315010, China
3. Shanghai Blood Center, Shanghai 200051, China
- Publication Type:Journal Article
- Keywords:
hemolytic anemia;
ceftizoxime sodium;
drug antibodies;
complement activation
- From:
Chinese Journal of Blood Transfusion
2025;38(9):1230-1235
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the laboratory testing methods and clinical management strategies for immune hemolytic anemia induced by Ceftizoxime sodium drug-dependent antibodies. Methods: Patient blood samples were subjected to blood typing, direct antiglobulin test, and unexpected antibody identification. Ceftizoxime sodium drug-dependent antibodies were detected using the immune complex method and drug-sensitized red cell method. The properties and titers of the drug antibodies were further assessed. Flow cytometry was used to assess the complement activation capacity of the drug antibodies in vitro. Results: Direct antiglobulin tests (IgG and C3d) were positive. Ceftizoxime sodium drug-dependent antibodies were identified using both the immune complex method and the sensitized red cell method, their titers significantly increased following the addition of the drug. Flow cytometry confirmed the complement activation capability of these antibodies and identified 30 minutes as the optimal time for activation in vitro. The patient's condition improved rapidly after drug withdrawal and supportive transfusion, resulting in a favorable outcome. Conclusion: Ceftizoxime sodium can cause drug-induced immune hemolytic anemia via complement activation mediated by drug-dependent antibodies. Serological testing is essential for diagnosing drug-induced hemolytic anemia. Clinicians should be vigilant for this adverse reaction. The offending drug must be promptly discontinued, and supportive care should be initiated upon the onset of symptoms.
