One center's experience: the serology and drugs associated with XXXX immune @entity5714 --a new paradigm.

@entity1 @entity114 @entity910 @entity2886 @entity22818 @entity5506 @entity4807 @entity5126 @entity5714 @entity12092 @entity2142
BACKGROUND: @entity5714 ( @entity5714 ) is an uncommon finding characterized by a sudden decrease in hemoglobin after treatment with the putative drug. The full range of drugs causing @entity5714 and the initial serologic presentation are not fully appreciated. This work identifies additional drugs associated with @entity5714 and offers additional insights about diagnosis. STUDY DESIGN AND METHODS: A 20-year retrospective review of testing in one laboratory was performed. @entity1 sex, age, medication history, initial direct antiglobulin test (DAT) and indirect antiglobulin test, method of drug-dependent antibody ( @entity22818 ) detection, and specificity were reviewed. RESULTS: Seventy-one @entity1 with 73 DDAs to 23 different drugs were identified. The following @entity22818 specificities were identified: @entity2886 (37), @entity114 and/or @entity114 derivatives (12), nonsteroidal anti-inflammatory drugs (NSAIDs) (11), @entity4807 and/or @entity5126 (7), and others (6). Fifty-two percent (37) were due to cephalosporins with 27 @entity12092 -dependent antibodies detected. Four NSAIDs required urinary metabolite for detection. DAT was strongly positive, at least 2+, in 75 percent (51/68) of @entity1 with a positive DAT. Initial eluate was negative in 52 @entity1 , weak positive (<2+) in 14 @entity1 , and strong positive (>or=2+) in 2 @entity1 . Serologic results showed characteristics of warm @entity5506 ( @entity5506 ) in 22 or 31 percent of all cases and cold-reactive @entity5506 in 2 cases. CONCLUSIONS: It is important to consider @entity5714 when a @entity1 serologically presents as either warm- or cold-type @entity5506 to avoid erroneous diagnosis. Based on these findings, the strength of the initial DAT is much stronger than previously reported for all types of @entity910 immune @entity2142 . This report is also unique in the number of NSAIDs reported. A new classification of categorizing @entity22818 is proposed.
