Çocuk Sağlığı ve Hastalıkları Dergisi
2009 , Vol 52 , Num 3
Seftriaksonla ilişkili hemolitik anemi: Bir vaka takdimi
Atatürk Üniversitesi Tıp Fakültesi Pediatri Yardımcı Doçenti1,Pediatri Doçenti2,Pediatri Profesörü3,
Drug-induced hemolytic anemia (HA) is a very rare state in childhood.
Second- and third-generation cephalosporins are the most common cause
of drug-induced HA. More than 50% of all reported cases of HA associated
with third-generation cephalosporins are related to ceftriaxone. We herein
report a six-year-old girl who developed HA during ceftriaxone treatment.
She received intravenous ceftriaxone, which was combined with vancomycin
and teicoplanin for purulent meningitis. Vancomycin treatment was withdrawn
because she developed a maculopapular rash. When she appeared pale and
had vomiting, tachypnea, and back pain, laboratory investigations revealed:
hemoglobin 4.3 g/dl, reticulocytes 1%, lactate dehydrogenase (LDH)
1346 U/L, total bilirubin 11.8 g/dl, direct bilirubin 2.9 g/dl, haptoglobin
13.9 mg/dl, urobilinogen (+2), and direct Coombs test (positive). HA was
assumed to be induced by ceftriaxone and ceftriaxone treatment was withdrawn.
Therapy was completed with teicoplanin. By the second week after discharge
from the hospital, her hemoglobin level was stable.
Anahtar Kelimeler :
hemolitik anemi, seftriakson.