Korean J Blood Transfus.  2011 Apr;22(1):65-69.

A Case of Cimetidine-induced Immune Hemolytic Anemia

Affiliations
  • 1Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. hyejin@kcch.re.kr
  • 2Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
  • 3Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

There have been 5 case reports about immune hemolytic anemia related with cimetidine, but there has been no such report in Korea. A sixty-four-year-old woman was admitted to the emergency department in a coma. She was diagnosed with diffuse large B-cell lymphoma 5 years ago and she achieved a complete remission after treatment. She was in a state of shock, and her blood pressure was 70/40 mmHg. The laboratory test results were consistent with hemolytic anemia (HA) as follows: hemoglobin: 1.9 g/dL, corrected reticulocyte count: 2%, total/conjugated bilirubin: 6.4/2.1 mg/dL, lactate dehydrogenase: 1,083 U/L and haptoglobin <10 mg/dL. She had a history of taking the drugs including cimetidine, acetaminophen and etizolam for two days. She urgently received transfusion of 3 units of packed red blood cells and then she regained consciousness. To investigate the relation between cimetidine and HA, we subsequently performed a drug-induced immune complex test and an antibody test by using cimetidine, AB serum and phosphate-buffered saline. The results proved that cimetidine was the cause of the HA. Patient was treated with steroid, and the following laboratory tests showed rapid improvement. This is the first case report from Korea that shows the causal relationship between cimetidine and immune HA.

Keyword

Hemolytic anemia; Cimetidine; Drug-induced

MeSH Terms

Acetaminophen
Anemia, Hemolytic
Antigen-Antibody Complex
Blood Pressure
Cimetidine
Coma
Consciousness
Diazepam
Emergencies
Erythrocytes
Female
Haptoglobins
Humans
Korea
Lactic Acid
Lymphoma, B-Cell
Reticulocytes
Shock
Acetaminophen
Antigen-Antibody Complex
Cimetidine
Diazepam
Haptoglobins
Lactic Acid
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