Drug-induced immune hemolytic anemia is a blood disorder that occurs when a medicine triggers the body's defense (immune) system to attack its own red blood cells. This causes red blood cells to break down earlier than normal, a process called hemolysis.
In some cases, a drug can cause the immune system to mistake your own red blood cells for foreign substances. The body responds by making antibodies then against the red blood cells. The antibodies attach to red blood cells and cause them to break down too early.
Drugs that can cause this type of hemolytic anemia include:
- Cephalosporins (a class of antibiotics) -- most common cause
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Penicillin and its derivatives
- Phenazopyridine (pyridium)
A rare form of the disorder is hemolytic anemia from a lack of glucose-6 phosphate dehydrogenase (G6PD). In this case, the breakdown of red blood cells is due to a certain type of stress in the cell.
Drug-induced hemolytic anemia is rare in children.
- Dark urine
- Pale skin color
- Rapid heart rate
- Shortness of breath
- Yellow skin color (jaundice)
Stopping the drug that is causing the problem may relieve or control the symptoms.
You may need to take a medicine called prednisone to reduce the immune response against the red blood cells. Special blood transfusions may be needed to treat severe symptoms
The outcome is good for most people if they stop taking the drug that is causing the problem.
Death caused by severe anemia is rare.
When to Contact a Medical Professional
See your health care provider if you have symptoms of this condition.
Avoid the drug that caused this condition.
Immune hemolytic anemia secondary to drugs; Anemia - immune hemolytic - secondary to drugs
Schwartz RS. Autoimmune and intravascular hemolytic Anemias. In: Goldman L, Schafer AI, eds.Goldman's Cecil Medicine
Jager U, Lechner K. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds.Hematology: Basic Principles and Practice
Price EA, Schrier SL, Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds.Hematology: Basic Principles and Practice
Update Date 3/3/2013
Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.