May 13, 1968

Hemolytic Anemia Caused By Penicillin

Author Affiliations

Kansas City, Mo

JAMA. 1968;204(7):635. doi:10.1001/jama.1968.03140200075032

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To the Editor:—  Although washed normal human erythrocytes suspended in saline are rapidly hemolyzed when exposed to 25 mg/ml of cephalothin, no hemolysis was detected after exposure of whole blood mixed with anticoagulant acid citrate dextrose solution to 25 mg/ml of cephalothin for four hours. It seems likely that binding of cephalothin by plasma proteins inhibits its hemolytic action.The half-life of autologous51Crtagged cephalothin-treated erythrocytes was five days in a man with autoimmune hemolytic anemia. His hematocrit reading (16%) approximated that (19%) of the patient with antipenicillin antibodies at the time the survival studies were done. The proportions of erythrocytes, plasma proteins, and cephalothin were similar in the cephalothintreated erythrocyte survival studies of the two patients. It seems unlikely that the much shorter cephalothin-treated erythrocyte half-life of 135 minutes in the patient with antipenicillin antibodies was due to direct damage of the erythrocytes by cephalothin. However, the possibility