Drug-induced immune hemolytic anemia

Alternative names:

anemia - immune hemolytic - secondary to drugs; immune hemolytic anemia secondary to drugs

Symptoms:

• fatigue
• pale color
• shortness of breath
• rapid heart rate
• yellow skin color (jaundice)
• dark urine

Signs and tests:

A physical examination shows an enlarged spleen.

• A direct Coombs' test is positive.
• An indirect Coombs' test is positive if the offending drug is added to the test.
• Indirect bilirubin levels are elevated.
• Serum haptoglobin may be low.
• Hemoglobin may be present in the urine.
• Hemosiderin may be present in the urine.
• Urine and fecal urobilinogen are increased.
• An absolute reticulocyte count is elevated.
• A CBC shows red blood cell count and hemoglobin are low.
• A direct measurement of the red cell longevity by isotope tagging techniques shows a decreased life span. See RBC (nuclear) scan.