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Ceftizoxime 투약 후 면역용혈빈혈 및 다발장기부전
허진영 ( Jin-young Huh ),안아리 ( Ari Ahn ),김형석 ( Hyungsuk Kim ),권석운 ( Seog-woon Kwon ),안수종 ( Sujong An ),이재용 ( Jae Yong Lee ),권병수 ( Byoung Soo Kwon ),오은혜 ( Eun Hye Oh ),박도현 ( Do Hyun Park ),허진원 ( Jin Won H 영남대학교 의과대학 2017 Yeungnam University Journal of Medicine Vol.34 No.1
Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure ― shortly after the infusion of ceftizoxime ― the patient`s mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.