Drug Induced Immune Hemolytic Anemia Caused by Levofloxacin: A Case Report

Abstract

Drug Induced Immune Hemolytic Anemia (DIIHA) is extremely rare. We report a rare but life-threatening DIIHA due to levofloxacin. This is only the second such case reported in literature. A 51-year-old lady was treated with levofloxacin 750 mg/day for a lung infection. After 4-5 days of therapy, she complained of fatigue. She was found to have hemolysis with positive Coomb’s-test and IgG autoantibody. We identified levofloxacin as the probable culprit using the Naranjo probability scale. After stopping the drug and initiating steroids, the patient’s hematological parameters stabilized. The diagnosis of DIIHA is made by a history of intake of offending drug, clinical and laboratory features of hemolysis and presence of a positive Coomb’s test. An autoantibody screen most commonly is positive for warm antibodies (IgG type). It is essential for clinicians to recognize this rare complication due to a commonly prescribed medication, stop the offending drug and initiate corticosteroids.

Keywords

• levofloxacin
• hemolytic anemia
• drug induced immune hemolytic anemia