Drug induced hemolytic anemia

Abstract

Background. Drug-induced hemolytic anemia may occur in varies of time after administration of the drug, and often occurs in an acute and severe form. It is a disease caused by the breakdown of erythrocytes, resulting in an imbalance between the rate of synthesis and breakdown of erythrocytes. Objective of the study. Analyses of new results regarding the mechanisms behind drug induced hemolytic anemia and which drugs can produce this side effect. Material and methods. This article is based on data collected from several articles available on PubMed, PMC, Google Scholar, NCBI that have been published since 2018. Results. Drugs that cause hemolytic anemia include: cephalosporins, quinidine, ibuprofen, methyldopa, levodopa etc. Cephalosporins were found to trigger hemolytic anemia due to an interaction between cefazolin coated erythrocytes with preexisting anti-penicillin antibodies in a patient with allergy to penicillin, it was majorly due to formation of an immune complex. Quinidine was found to cause hemolytic anemia by forming immune complexes which attached to erythrocytes and caused acute intravascular hemolysis. Ibuprofen were found to form immune complexes in the same way that methyldopa an antihypertensive and levodopa, a dopamine agonist did, resulting in hemolytic anemia. Nitrofurantoin was used in a patient with quinolone-sensitivity, and it induced hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency. Conclusion. Hemolysis of erythrocytes is one of the main side effects caused by drugs. The administration of drugs must be individualized and based on their efficacy and harmlessness. Overall, we conclude that drugs can induce hemolytic anemia, and it must not be overlooked during treatment.