Rare case of tacrolimus-induced immune hemolytic anemia in a child after liver transplantation

IF 1.2 4区医学 Q4 HEMATOLOGY

Transfusion and Apheresis Science Pub Date : 2025-06-06 DOI:10.1016/j.transci.2025.104172

Bowei Cao, Yanhong Bu, Yongjun Wang, Ningjie Zhang

引用次数: 0

Abstract

Tacrolimus (FK506), a macrolide antibiotic derived from actinomycete fermentation products, has emerged as the primary clinical anti-rejection drug. Previous studies have shown that patients frequently encounter adverse effects, such as infections, hypertension, diabetes mellitus, hepatic impairment, and renal impairment. However, few occurrences of immune hemolytic anemia caused by tacrolimus have been reported. We present a patient with drug-induced immune hemolytic anemia caused by oral tacrolimus after liver transplantation. The patient's direct antiglobulin test is strongly positive(IgG type), with both serum antibody screening and red blood cell eluate antibody screening positive. Furthermore, the crossmatches in the anti-human globulin gel are incompatible. The manual polybrene method employed in the antibody screening and crossmatching tests eliminates interference from tacrolimus.

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他克莫司致儿童肝移植后免疫性溶血性贫血的罕见病例

他克莫司（FK506）是一种从放线菌发酵产物中提取的大环内酯类抗生素，已成为临床主要的抗排斥药物。以往的研究表明，患者经常会遇到不良反应，如感染、高血压、糖尿病、肝功能损害和肾功能损害。然而，他克莫司引起的免疫性溶血性贫血鲜有报道。我们报告一例肝移植术后口服他克莫司致药物性免疫性溶血性贫血。患者直接抗球蛋白试验强阳性（IgG型），血清抗体筛查和红细胞洗脱抗体筛查均阳性。此外，抗人球蛋白凝胶中的交叉配型是不相容的。在抗体筛选和交叉配型试验中采用人工聚烯法消除了他克莫司的干扰。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion and Apheresis Science 医学-血液学

CiteScore

3.60

自引率

5.30%

发文量

181

审稿时长

42 days

期刊介绍： Transfusion and Apheresis Science brings comprehensive and up-to-date information to physicians and health care professionals involved in the rapidly changing fields of transfusion medicine, hemostasis and apheresis. The journal presents original articles relating to scientific and clinical studies in the areas of immunohematology, transfusion practice, bleeding and thrombotic disorders and both therapeutic and donor apheresis including hematopoietic stem cells. Topics covered include the collection and processing of blood, compatibility testing and guidelines for the use of blood products, as well as screening for and transmission of blood-borne diseases. All areas of apheresis - therapeutic and collection - are also addressed. We would like to specifically encourage allied health professionals in this area to submit manuscripts that relate to improved patient and donor care, technical aspects and educational issues. Transfusion and Apheresis Science features a "Theme" section which includes, in each issue, a group of papers designed to review a specific topic of current importance in transfusion and hemostasis for the discussion of topical issues specific to apheresis and focuses on the operators'' viewpoint. Another section is "What''s Happening" which provides informal reporting of activities in the field. In addition, brief case reports and Letters to the Editor, as well as reviews of meetings and events of general interest, and a listing of recent patents make the journal a complete source of information for practitioners of transfusion, hemostasis and apheresis science. Immediate dissemination of important information is ensured by the commitment of Transfusion and Apheresis Science to rapid publication of both symposia and submitted papers.