Autoimmune Hemolytic Anemia, Erythrophagocytosis and Liver Dysfunction After Cefixime Use for Urinary Tract Infection in a Child
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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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The authors have no conflict of interests.
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