{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:54:56Z","timestamp":1790420096303,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2004,7,20]],"date-time":"2004-07-20T00:00:00Z","timestamp":1090281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2004,8]]},"abstract":"<jats:p><jats:bold>BACKGROUND:\u2002<\/jats:bold> Diclofenac (DCF) is a widely used nonsteroidal anti\u2010inflammatory drug implicated as a cause of immune hemolytic anemia. Drug derivatives have been suggested to be an important\u2014or probably the primary\u2014immunizing agent in drug\u2010induced immune reactions. A systematic evaluation of 12 patients with DCF\u2010induced immune hemolysis is reported.<\/jats:p><jats:p><jats:bold>STUDY DESIGN AND METHODS:\u2002<\/jats:bold> All sera samples were evaluated with standard serologic tests for the detection of red blood cells (RBCs) and platelet (PLT) antibodies in the presence of DCF, DCF\u2010urine (DCF\u2010U), and five chemically defined metabolites.<\/jats:p><jats:p><jats:bold>RESULTS:\u2002<\/jats:bold> Twelve patients\u2019 sera samples reacted with DCF\u2010U, but only 9 reacted with DCF. When derivatives were tested, no metabolite was recognized by all sera samples (although 4\u2032\u2010OH\u2010DCF was recognized by 11\/12), and no metabolite remained unrecognized. As demonstrated with Rh<jats:sub>null<\/jats:sub> cells, the Rh complex may represent an important, but not the only, target protein for which drug\u2010dependent antibodies are specific. PLT\u2010reactive antibodies were not detectable.<\/jats:p><jats:p><jats:bold>CONCLUSION:\u2002<\/jats:bold> There is evidence that patients with DCF\u2010induced immune hemolysis produce a broad spectrum of anti\u2010DCF\/RBC antibodies. 4\u2032\u2010OH\u2010DCF seems to represent the most immunogenic metabolite. Nevertheless, all patients\u2019 sera samples contain a mixture of antibodies that recognize several and distinguishable epitopes. These epitopes consist of different drug metabolites and a target protein on the RBC surface, which appears to be the Rh complex in many, but not in all, cases. Additional target proteins remain to be identified.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2004.04025.x","type":"journal-article","created":{"date-parts":[[2004,7,20]],"date-time":"2004-07-20T11:58:25Z","timestamp":1090324705000},"page":"1226-1230","source":"Crossref","is-referenced-by-count":13,"title":["Diclofenac\u2010induced antibodies against red blood cells are heterogeneous and recognize different epitopes"],"prefix":"10.1111","volume":"44","author":[{"given":"Ulrich J.H.","family":"Sachs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sentot","family":"Santoso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lida","family":"R\u00f6der","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Smart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Bein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"Kroll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,7,20]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-7963(90)70249-0"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1991.tb08624.x"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1996.d01-1947.x"},{"key":"e_1_2_7_5_2","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1182\/blood.V68.6.1285.1285","article-title":"Rh blood group\u2010specific antibodies in immune hemolytic anemia induced by nomifensine","volume":"68","author":"Salama A","year":"1986","journal-title":"Blood"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V90.1.407"},{"key":"e_1_2_7_7_2","first-page":"116","article-title":"A review of spontaneous reportedly adverse drug reactions with diclofenac sodium (Voltarol)","volume":"18","author":"Ciucci AG","year":"1980","journal-title":"Rheumatol Rehabil"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1986.tb02662.x"},{"key":"e_1_2_7_9_2","first-page":"54","article-title":"Hypersensitivity to diclofenac with acute hepatitis, immune\u2010haemolytic anaemia, thrombocytopenia and renal involvement","volume":"16","author":"Salvarini C","year":"1984","journal-title":"Ital J Gastroenterol"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1423-0410.1997.7220121.x"},{"key":"e_1_2_7_11_2","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1182\/blood.V53.3.396.396","article-title":"Immune hemolytic anemia and thrombocytopenia secondary to quinidine: in vitro studies of the quinidine\u2010dependent red cell and platelet antibodies","volume":"53","author":"Zeigler Z","year":"1979","journal-title":"Blood"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00340.x"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.293.6560.1474"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1989.29789369685.x"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1994.34394196626.x"},{"key":"e_1_2_7_16_2","volume-title":"Human Blood Groups","author":"Daniels G","year":"1995"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1983.tb04127.x"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.1969.tb04911.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1537-2995.2004.04025.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1537-2995.2004.04025.x","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1537-2995.2004.04025.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T13:29:24Z","timestamp":1697290164000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1537-2995.2004.04025.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,7,20]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2004,8]]}},"alternative-id":["10.1111\/j.1537-2995.2004.04025.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1537-2995.2004.04025.x","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,7,20]]}}}