Autoimmune Hemolytic Anemia, Erythrophagocytosis and Liver Dysfunction After Cefixime Use for Urinary Tract Infection in a Child

  • Zühre KayaEmail author
  • Fulya Kürekçi
  • Emine Akkuzu
  • Seniz Göral
  • Gökhan Kalkan

Dear editor,

Drug-induced hemolytic anemia and hepatitis associated with ceftriaxone administration have been reported previously; however, these have rarely been described in association with erythrophagocytosis [ 1, 2, 3]. We present a case of 3-year-old boy who developed severe autoimmune hemolytic anemia (AIHA) and liver dysfunction in the first week of cefixime use at a dose of 8 mg/kg/day orally in single daily dose for urinary tract infection. On examination, he was found to have mental and behavioral changes and, jaundice. At that time, testing indicated platelet count 151,000/mm 3, leukocyte count 17.900/mm 3, hemoglobin (Hb) concentration 5.1 g/dL and reticulocytes 8.5%. Peripheral blood smear and bone marrow findings were consistent with erythrophagocytosis (Fig.  1). Biochemical investigations revealed elevated AST (259 IU/dL), ALT (316 IU/dL), bilurubin (7.4 mg/dL) and lactate dehydrogenase (1750 IU/L) and low haptoglobin as 10 mg/dL (normal range, 30–200 mg/dL). The serum...


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Conflict of interests

The authors have no conflict of interests.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from parents.


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© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  1. 1.Unit of Pediatric Hematology, Department of PediatricsGazi University School of MedicineBeşevler, AnkaraTurkey
  2. 2.Department of Intensive Care UnitGazi University Medical FacultyAnkaraTurkey
  3. 3.Unit of Blood BankGazi University Medical FacultyAnkaraTurkey

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