MCQ Hematology Answer 21

The Correct Asnwer is E

Explanation:

Recognize drug-induced immune hemolytic anemia of the hapten type, classically developing in patients exposed to high doses of penicillin.

The other types of drug-induced immune hemolytic anemia are the [agr ]-methyldopa type (the most common) and the quinidine type (occurring with quinidine, quinine, stibophen, chlorpromazine, and sulfonamides).

In this patient the strongly positive direct Coombs test shows that this is an immune hemolytic anemia.

Three findings suggest the diagnosis of a drug-induced mechanism rather than an autoimmune mechanism:
(1) the patient received a cephalosporin known to induce a hapten-type reaction,
(2) routine tests for RBC antibodies in the patient's serum were negative even though the patient's RBCs were strongly coated for antibody, and
(3) eluate from the patient's RBCs was not reactive with normal RBCs.

In most cases of drug-induced immune hemolytic anemia, the RBC antibodies are detectable only if the offending drug is added to the in vitro system.

Category: Hematology MCQs