Acute Hemolytic Anemia Induced by Levofloxacin in a Woman With G6PD Deficiency: A Case Report
Abstract
Introduction: Glucose 6-Phosphate Dehydrogenase deficiency (G6PD) is an X-linked recessive disorder recognized as the most prevalent enzyme deficiency around the world. G6PD deficiency has a high prevalence in Iran, especially in the northern regions. As we know, hemolysis in G6PD patients was not reported with levofloxacin previously.
Case Report: In this report, we introduce a 54-year-old G6PD deficient woman who experienced the symptoms of hemolytic anemia following completion of treatment with levofloxacin.
Result: After ruling out other causes of hemolysis, by using the Naranjo scale, levofloxacin was considered as a possible cause of hemolysis.
Conclusion: Though the hemolytic anemia induced by levofloxacin is extremely rare in G6PD deficient patients, drug-induced hemolytic anemia should be considered as one of the differential diagnoses. It would be appropriate to use an alternative antibiotic instead of levofloxacin in a G6PD deficient patient.
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[4] Chan TK, Chesterman CN, McFadzean AJ, Todd D. The survival of glucose-6-phosphate dehydrogenase-deficient erythrocytes in pa- tients with typhoid fever on chloramphenicol therapy. The Journal of Laboratory and Clinical Medicine. 1971; 77(2):177-84. [PMID]
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[9] Mesbah-Namin SA, Sanati MH, Mowjoodi A, Mason PJ, Vulliamy TJ, Noori-Daloii MR. Three major glucose-6-phosphate dehydro- genase-deficient polymorphic variants identified in Mazandaran state of Iran. British Journal of Haematology. 2002; 117(3):763-4. [DOI:10.1046/j.1365-2141.2002.03483.x] [PMID]
[10] Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reac- tions. Clinical Pharmacology and Therapeutics. 1981; 30(2):239-45. [DOI:10.1038/clpt.1981.154] [PMID]
[11] Dhaliwal G, Cornett PA, Tierney Jr LM. Hemolytic anemia. Ameri- can Family Physician. 2004; 69(11):2599-606. [PMID]
[12] Frank JE. Diagnosis and management of G6PD deficiency. Ameri- can Family Physician. 2005; 72(7):1277-82. [PMID]
[13] Suaifan GARY, Mohammed AAM. Fluoroquinolones structural and medicinal developments (2013-2018): Where are we now? Bioor- ganic & Medicinal Chemistry. 2019; 27(14):3005-60. [DOI:10.1016/j. bmc.2019.05.038] [PMID]
[14] Youngster I, Arcavi L, Schechmaster R, Akayzen Y, Popliski H, Shi- monov J, et al. Medications and glucose-6-phosphate dehydro- genase deficiency: An evidence-based review. Drug Safety. 2010; 33(9):713-26. [DOI:10.2165/11536520-000000000-00000] [PMID]
[15] Sansone S, Rottensteiner J, Stocker J, Rosanelli C, Wiedermann CJ. Ciprofloxacin-induced acute haemolytic anaemia in a patient with glucose-6-phosphate dehydrogenase Mediterranean defi- ciency: A case report. Annals of Hematology. 2010; 89(9):935-7. [DOI:10.1007/s00277-010-0903-7] [PMID]
[16] López PC, García LL, Ruiz JM, Fernández EM, López PC. Anemia hemolítica aguda por Ciprofloxacino. Revista de Medicina de Famil- ia. 2016; 20(22):1-3. https://www.revistafml.es/upload/ficheros/ noticias/201608/caso_clinico__anemia_hemolitica.pdf
[2] Domingo GJ, Advani N, Satyagraha AW, Sibley CH, Rowley E, Kal- noky M, et al. Addressing the gender-knowledge gap in glucose- 6-phosphate dehydrogenase deficiency: Challenges and oppor- tunities. International Health. 2019; 11(1):7-14. [DOI:10.1093/ inthealth/ihy060] [PMID] [PMCID]
[3] D’Alessandro A, Fu X, Kanias T, Reisz JA, Culp-Hill R, Guo Y, et al. Donor sex, age and ethnicity impact stored red blood cell antioxi- dant metabolism through mechanisms in part explained by glucose 6-phosphate dehydrogenase levels and activity. Haematologica. 2020; 106(5):1290-1302. [DOI:10.3324/haematol.2020.246603] [PMID] [PMCID]
[4] Chan TK, Chesterman CN, McFadzean AJ, Todd D. The survival of glucose-6-phosphate dehydrogenase-deficient erythrocytes in pa- tients with typhoid fever on chloramphenicol therapy. The Journal of Laboratory and Clinical Medicine. 1971; 77(2):177-84. [PMID]
[5] Luzzatto L, Seneca E. G6PD deficiency: A classic example of phar- macogenetics with on-going clinical implications. British Journal of Haematology. 2014; 164(4):469-80. [DOI:10.1111/bjh.12665] [PMID] [PMCID]
[6] Jamwal M, Sharma P, Das R. Laboratory approach to hemo- lytic anemia. The Indian Journal of Pediatrics. 2020; 87(1):66-74. [DOI:10.1007/s12098-019-03119-8] [PMID]
[7] Oh YR, Carr-Lopez SM, Probasco JM, Crawley PG. Levofloxacin-in- duced autoimmune hemolytic anemia. Annals of Pharmacotherapy. 2003; 37(7-8):1010-3. [DOI:10.1345/aph.1C525] [PMID]
[8] Glader B. Diagnosis and management of Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency [Internet]. 2019 [Updated 2021 March 17]. Available from: https://www.uptodate.com/contents/ diagnosis-and-management-of-glucose-6-phosphate-dehydroge- nase-g6pd-deficiency
[9] Mesbah-Namin SA, Sanati MH, Mowjoodi A, Mason PJ, Vulliamy TJ, Noori-Daloii MR. Three major glucose-6-phosphate dehydro- genase-deficient polymorphic variants identified in Mazandaran state of Iran. British Journal of Haematology. 2002; 117(3):763-4. [DOI:10.1046/j.1365-2141.2002.03483.x] [PMID]
[10] Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reac- tions. Clinical Pharmacology and Therapeutics. 1981; 30(2):239-45. [DOI:10.1038/clpt.1981.154] [PMID]
[11] Dhaliwal G, Cornett PA, Tierney Jr LM. Hemolytic anemia. Ameri- can Family Physician. 2004; 69(11):2599-606. [PMID]
[12] Frank JE. Diagnosis and management of G6PD deficiency. Ameri- can Family Physician. 2005; 72(7):1277-82. [PMID]
[13] Suaifan GARY, Mohammed AAM. Fluoroquinolones structural and medicinal developments (2013-2018): Where are we now? Bioor- ganic & Medicinal Chemistry. 2019; 27(14):3005-60. [DOI:10.1016/j. bmc.2019.05.038] [PMID]
[14] Youngster I, Arcavi L, Schechmaster R, Akayzen Y, Popliski H, Shi- monov J, et al. Medications and glucose-6-phosphate dehydro- genase deficiency: An evidence-based review. Drug Safety. 2010; 33(9):713-26. [DOI:10.2165/11536520-000000000-00000] [PMID]
[15] Sansone S, Rottensteiner J, Stocker J, Rosanelli C, Wiedermann CJ. Ciprofloxacin-induced acute haemolytic anaemia in a patient with glucose-6-phosphate dehydrogenase Mediterranean defi- ciency: A case report. Annals of Hematology. 2010; 89(9):935-7. [DOI:10.1007/s00277-010-0903-7] [PMID]
[16] López PC, García LL, Ruiz JM, Fernández EM, López PC. Anemia hemolítica aguda por Ciprofloxacino. Revista de Medicina de Famil- ia. 2016; 20(22):1-3. https://www.revistafml.es/upload/ficheros/ noticias/201608/caso_clinico__anemia_hemolitica.pdf
| Files | ||
| Issue | Vol 6 No 4 (2021): July-August | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v6i4.7854 | |
| Keywords | ||
| Glucose 6-phosphate dehydrogenase (G6PD) deficiency Hemolytic Anemia Levofloxacin | ||
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How to Cite
1.
Salehifar E, Aliyali M, bazi aliyeh. Acute Hemolytic Anemia Induced by Levofloxacin in a Woman With G6PD Deficiency: A Case Report. CRCP. 2021;6(4):145-149.
