Blood Group-Specific Antibodies in Immune Hemolytic Anemia Induced by Nomifensine

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چکیده

Nomifensine (Mental. Alival; Hoechst. Frankfurt. FRG). an antidepressant drug. may cause immune hemolytic anemia (IHA) of the so-called immune complex type that is believed to occur by means of an innocent-bystander mechanism. In this report we describe findings that are not consistent with this mechanism in a patient with nomifensine-induced intravascular IHA associated with renal failure. In vitro studies showed a transitory positive direct antiglobulin test (DAT) due to lgG. 1gM. and C3 fixation. The causative antibodies were found to be (1 ) a drug-independent 1gM antibody in the serum and eluate that reacted only with E-positive RBC. although the patient’s RBC were Enegative; (2) an lgG antibody in the serum and initial eluates that showed a stronger reaction with e-positive than with e-negative or Rh,... RBC. but only in the presence of ex vivo antigen (ie. urine containing the drug and all its metabolities); and (3) an 1gM antibody in the serum and

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تاریخ انتشار 2005