Abstract
Drug-induced immune hemolytic anemia (DIIHA) is commonly attributed to cephalosporins. Ceftriaxone is the most frequently administered cephalosporin in patients with sickle cell disease. We present a pediatric patient with severe DIIHA (hemoglobin
Highlights
Drug-induced immune hemolytic anemia (DIIHA) is rare but potentially fatal
We present a pediatric patient with severe DIIHA who survived
The lack of a well-established incidence cannot be merely attributed to its rarity, as the incidence to other immune cytopenias has been documented [1]
Summary
Drug-induced immune hemolytic anemia (DIIHA) is rare but potentially fatal. Unlike other immune cytopenias, the incidence of DIIHA is poorly estimated and less well characterized [1]. This is important as ceftriaxone is the most common empiric antibiotic administered in children with sickle cell disease (SCD) in the United States This disproportionate incidence of high fatality rates from ceftriaxone-induced immune hemolytic anemia (CIIHA) is unique to children, as compared to adults [4], who have more comorbidities and poly-drug use [7]. We present a child with SCD who experienced recurrent, severe intravascular hemolysis and survived His course further highlights the rapidity of which ceftriaxone induces hemolysis in children (
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