Keywords
Hemolysis
Drugs
How to Cite
Abstract
Introduction: Anemia is characterized by a reduction in erythrocyte mass, measured by hemoglobin (Hb) concentration. Its etiologies are multifactorial, including nutritional deficiencies, blood loss and chronic diseases. Among the rare and serious causes are drug-induced anemias, which occur due to drug interactions that trigger the destruction of red blood cells. Methods: A bibliographic review was carried out in the main databases, resulting in the selection of 20 articles dealing with drug-induced hemolytic anemia. The inclusion criteria were articles published between 2016 and 2024, available in full and in English, Spanish or Portuguese. Results and Discussion: Antibiotics, especially penicillin and cephalosporins, are the main causes of drug-induced hemolytic anemia. Mechanisms involving drug interactions lead to the immunological destruction of red blood cells. Symptoms are non-specific and varied, including weakness, tachycardia and jaundice. Diagnosis requires clinical suspicion and laboratory tests, such as the direct antiglobulin test. Conclusion: The management of drug-induced hemolytic anemia involves discontinuing the causative drug, and glucocorticoids may be necessary in severe cases. Second-line therapies, such as splenectomy or immunosuppressants, are considered in situations of resistance to initial treatment. Interdisciplinary collaboration is essential for effective and individualized management.
References
BARCELLINI, W. Anemia Hemolítica Induzida por Drogas. Uptodate, [s. l.], 2022. Disponível em: Acesso em: 27 nov. 2023.
BARCELLINI, Wilma; FATTIZZO, Bruno. How I treat warm autoimmune hemolytic anemia. Blood, The Journal of the American Society of Hematology, v. 137, n. 10, 2021.
DE SANTIS, G. C. Anemia: definição, epidemiologia, fisiopatologia, classificação e tratamento. Medicina USP (Ribeirão Preto), v. 52, n. 3, p. 239-251, 2019.
DE OLIVEIRA, K. S. V. Anemias Induzidas por Fármacos. Academia de Ciência e Tecnologia, 2020. Disponível em: Acesso em: 26 nov. 2023.
FERRAZ, S.L.N. S et al. Anemia hemolítica induzida por medicamento: uma revisão sistemática. RECIMA21- Revista Científica Multidisciplinar, v. 3, n. 12, p. e3122463-e3122463, 2022.
GOMEZ, J.C et al. Drug-induced immune hemolytic anemia due to amoxicillin-clavulanate: a case report and review. Cureus, v. 12, n. 6, 2020.
HERNÁNDEZ MARTÍNEZ, A. et al. Anemia hemolítica associada a fármacos antimicrobianos. Asociación Mexicana de Infectología y Microbiología, v. 38, n. 3, p. 81-85, 2018.
HILL, A.; HILL, Q.A. Autoimmune hemolytic anemia. Hematology 2014, the American Society of Hematology Education Program Book, v. 2018, n. 1, 2018.
HILL, Q. A et al. The diagnosis and management of primary autoimmune haemolytic anaemia. British journal of haematology, v. 176, 2017.
HOFFBRAND, A. V. ; MOSS, P. A. H. Anemias Hemolíticas: Anemias Imunológicas induzidas por Fármacos. In: HOFFBRAND, A. V; MOSS, P.A. H. Fundamentos em Hematologia de Hoffbrand. 7. ed. Porto Alegre: Artmed, 2017, cap. 6, p. 70-71.
KIBLAWI, M. Early-onset antibiotic-induced autoimmune hemolytic anemia. Ibnosina Journal of Medicine and Biomedical Sciences, v. 12, n. 03, p. 215-219, 2020.
KULPA, J. et al. Probability of remaining in unsustained complete remission after steroid therapy withdrawal in patients with primary warm-antibody reactive autoimmune hemolytic anemia. Wiener klinische Wochenschrift, v. 128, 2016.
LECHNER, K.; JÄGER, U. How I treat autoimmune hemolytic anemias in adults. Blood, The Journal of the American Society of Hematology, v. 116, 2010.
MACHADO, Í.E et al. Prevalência de anemia em adultos e idosos brasileiros. Revista Brasileira de Epidemiologia, v. 22, 2019.
PACKMAN, C. H. Hemolytic anemia due to warm autoantibodies. Blood reviews, v. 22, 2008.
RENARD, D.; ROSSELET, A. Drug-induced hemolytic anemia: Pharmacological aspects. Transfusion Clinique et Biologique, v. 24, 2017.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Humberto Novais da Conceição, Marina Pezzetti Sanchez Diogo, Daniel Maximino de Sousa, Ana Beatriz Nunes Paiva do Amaral, Lucas Santana e Silva Maciel, Paulo Vitor Brito Oliveira Xavier De Paula, Letícia Sgarbossa, Alice Cassiano, Yolanda Luz Capistrano Brito, Beatriz Eler de Lima, Yago Azevedo Guerra, Vanessa Aparecida Carvalho Santos de Castro, Filipe Teixeira Dutra , Clara Pego de Andrade , Bruno Gonzaga Feitoza