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September 1967

Anemia, Positive Lupus and Rheumatoid Factors With Methyldopa: A Report of Three Cases

Author Affiliations

Framingham and Boston, Mass

From the Department of Hematology and Medicine, Framingham (Mass) Union Hospital, and the Department of Medicine, Boston University Medical Center, Boston.

Arch Intern Med. 1967;120(3):321-326. doi:10.1001/archinte.1967.00300030063012

There have been 22 reported cases of Coombs'-positive hemolytic anemia in patients under hypertensive treatment with methyldopa (Aldomet).1-7,18 In addition, 56 cases have been reported in which the direct Coombs' test was positive without hemolytic anemia.8-10,18 It would appear that the incidence of Coombs' positivity is dosage dependent.9 The purpose of this report is to describe three cases of Coombs'-positive hemolytic anemia in patients treated with methyldopa. The rheumatoid factor and the lupus erythematosus (LE) preparation were also positive in two of these cases. These latter two antibodies are described for the first time in patients given this drug.

Report of Cases 

Case 1.  —A 71-year-old white married woman was admitted to this hospital with complaints of progressive dyspnea and weakness of approximately one month's duration. The patient had essential hypertension diagnosed in 1949 and had been on methyldopa therapy from June 5, 1964, to the day

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