Hemolytic Anemias and Anemia Due to Acute Blood Loss Part 11 Table 101-5 Drugs that Carry Risk of Clinical Hemolysis in Persons with G6PD Deficiency Risk Doubtful Risk Antimalarials
Trang 1Chapter 101 Hemolytic Anemias and Anemia
Due to Acute Blood Loss
(Part 11)
Table 101-5 Drugs that Carry Risk of Clinical Hemolysis in Persons with G6PD Deficiency
Risk
Doubtful Risk
Antimalarials Primaquine Chloroq
uine
Quinine
roguanil
Sulphonamides/s
ulphones
Sulphametoxaz ole
Sulfasala zine
Sulfisoxaz ole
Trang 2Others Sulfadim
idine
Sulfadiazi
ne
Antibacterial/anti
biotics
Cotrimoxazole Ciproflo
xacin
Chloramp henicol
cin
p-Aminosalicylic acid
Antipyretic/analg
esics
Acetanilide Acetylsa
licylic acid high dose (>3 g/d)
Acetylsali cylic acid <3 g/d
Trang 3Phenazopyridin
e (Pyridium)
phen
Other Naphthalene Vitamin
K analogues
Doxorubic
in
acid >1 g
Probeneci
d
ase
Table 101-6 Diseases/Clinical Situations with Predominantly Intravascular Hemolysis
riate
Comme
Trang 4Time Course Mechanism Diagnostic
Procedure
nts
Mismatche
transfusion
Abrupt Nearly
always ABO incompatibility
Repeat cross match
Paroxysmal
nocturnal
hemoglobinuria
(PNH)
Chronic with acute exacerbations
Comple ment (C)-mediated destruction of CD59(–) red cells
Flow cytometry to display a CD59(–) red cell population
Exacerba tions due to C activation
through any pathway
Paroxysmal
cold
hemoglobinuria
(PCH)
lysis of normal red cells
Test for
Donath-Landsteiner antibody
Often triggered by viral infection
Septicemia Very
acute
Exotoxi
ns produced by
Blood cultures
Other organisms may
Trang 5Clostridium perfringens
be responsible
Microangio
pathic
Acute
or chronic
Red cell fragmentation
Red cell morphology on blood smear
Different causes ranging from
endothelial damage to hemangioma to leaky prosthetic heart valve
March
hemoglobinuria
ical destruction
Targete
d history taking
tion of older fraction of
G6PD-deficient red
G6PD assay
Triggere
d by ingestion
of large dish of fava beans; but trigger can be
Trang 6cells infection or
drug instead