Cefotetan-Induced Hemolytic Anemia: Case Series and Review

Lim, Kathlyn; Tran, Hai; Hirai-Yang, Angela; Vakil, Niyati; Marks, Gregory; Klapper, Ellen

doi:10.1177/0897190018798198

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…The most common drugs associated with AIHA in the 1970s were methyldopa and penicillin, in the beginning of the 2000s were cefotetan, ceftriaxone [11,44] and piperacillin [49]. Current data indicates as drugs inducing AIHA antibiotics (cefotetan [50,51], ceftriaxone [52][53][54][55], penicillins [56], trimethoprim-sulfamethoxazole [57]), NSAIDs (diclofenac [47]), antineoplastic/chemotherapeutic drugs [11,12,46,58], cimetidine [59], and contrast media [60]. Our patient did not receive any of the medications known to be associated with drug-associated AIHA, and transfusions of PRBC were performed when anaemia became life-threatening.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Challenges in Orthogeriatric Patients with Cold Agglutinin Haemolytic Anaemia: Case Report and Management Algorithm

2022

Ann Case Report

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Most published reports on cold agglutinin (CA) haemolytic anaemia (CAHA), a rare condition with significant perioperative management challenges, are from patients who have undergone cardiothoracic surgery with hypothermia. Here, we report a hip fracture patient with CAHA, and review the perioperative management. This is the second published case report regarding CAHA in an orthopaedic patient. An 86 year old female with a 4-year history of recurrent episodes of CAHA and multiple comorbidities (atrial fibrillation, hypertension, strokes, secondary epilepsy, vascular dementia, and type 2 diabetes mellitus complicated by diabetic retinopathy, osteoporosis, urinary incontinence, recurrent urinary tract infections, and multinodular goitre) was admitted because of a hip fracture. She was commenced on prednisolone a month prior the hip fracture. On admission, her haemoglobin was 69 g/L, lactate dehydrogenase 494 U/L, haptoglobin <0.1 g/L and the blood film showed red blood cell agglutination at room temperature, which dissociated at 37 o C. She required transfusion of 5 units of packed red blood cells during her admission. Her management included intensive temperature monitoring, use of body thermal blanket, warming intravenous and irrigation fluids and medications before administration. Surgery was performed under general anesthesia on the 4th admission day. She received unfractionated heparin for venous thromboembolism prophylaxis, antibiotics for wound infection prophylaxis, continued prednisolone, and started anti-osteoporotic medications. The patient was discharged to another hospital for rehabilitation on the 7th postoperative day. Perioperative examination and treatment of orthogeriatric patients with CAHA is challenging. The pathophysiology of CAHA is shortly revied and a management algorithm is presented.

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