PMID: 9531349Apr 8, 1998Paper

Positive direct antiglobulin tests and haemolytic anaemia following therapy with beta-lactamase inhibitor containing drugs may be associated with nonimmunologic adsorption of protein onto red blood cells

British Journal of Haematology
G Garratty, Patricia A Arndt

Abstract

A high incidence (39%) of positive direct antiglobulin tests (DATs) has been reported in patients taking Unasyn [ampicillin sodium plus sulbactam sodium (a beta-lactamase inhibitor)]. Three of four patients, with positive DATs, receiving Unasyn or Timentin [ticarcillin disodium plus clavulanate potassium (also a beta-lactamase inhibitor)] developed a haemolytic anaemia (HA) associated with a positive DAT, which resolved when drug therapy was stopped. The patients' sera did not react with red blood cells (RBCs) in the presence of Unasyn or Timentin, but when drug-treated RBCs were tested, patients' sera and normal sera reacted equally by indirect antiglobulin test. Following incubation in normal sera, RBCs treated with Unasyn, Timentin, Augmentin (amoxicillin + clavulanate), sulbactam and clavulanate reacted with anti-human globulin and anti-human albumin (an index of non-specific adsorption); RBCs treated with ampicillin and amoxicillin were nonreactive. The beta-lactamase inhibitors sulbactam and clavulanate seem to cause nonimmunologic adsorption of protein onto RBCs in vitro. This may explain the high incidence of positive DATs detected in patients taking Unasyn, which contains sulbactam. It was not possible to prove that th...Continue Reading

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Citations

Feb 24, 2006·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Erkan DemirkayaFaysal Gok
Jan 25, 2000·Transfusion·M PujolE Feliu
Dec 17, 2009·Hematology·George Garratty
Apr 17, 2012·Expert Opinion on Drug Safety·George Garratty
Jun 21, 2011·American Journal of Clinical Pathology·Arand PierceUNKNOWN Education Committee of the Academy of Clinical Laboratory Physicians and Scientists
Jul 24, 2010·Blood Reviews·George Garratty
Apr 26, 2005·Transfusion·Behrouz Mansouri TaleghaniAbdulgabar Salama
May 26, 2004·Transfusion·Vivien M Y ChenRobert L Flower
Jun 21, 2008·Transfusion·Marina MartinengoGiorgio Reali
Jul 26, 2005·Seminars in Hematology·Patricia A Arndt, George Garratty
Jan 5, 2010·The Korean journal of laboratory medicine·Eun Jung BaekHyun Ok Kim
Apr 16, 2020·Case Reports in Hematology·H G C S KarunathilakaA H N Fernando

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