Drugindependent autoimmune hemolytic anemias

In these cases the antibody reacts with the red cell in the absence of the drug. The anti-red cell autoantibodies seem to be serologically identical to those of 'idiopathic' warm-type autoimmune hemolytic anemia. The great majority of cases have followed the use of the anti-hypertension drug a-methyldopa (Aldomet). The red cells are coated with IgG and the serum contains autoantibodies which characteristically have Rh specificity.

In patients receiving a-methyldopa the autoantibody is often present (15-20%), but hemolysis is not common (<1 %). Studies of reticuloendothelial clearance in patients receiving a-methyldopa suggest that the drug itself may blockade the reticuloendothelial system in most patients, effectively blocking cell destruction by the autoantibody.

Other drugs that have been reported to act in a similar fashion to a-methyldopa include chlor-diazepoxide (Librium), mefenamic acid (Ponstan), flufenamic acid and indomethacin.

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