{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:54:54Z","timestamp":1790420094736,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2011,9,12]],"date-time":"2011-09-12T00:00:00Z","timestamp":1315785600000},"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":[[2012,4]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Drug\u2010dependent antibodies have been associated with approximately 10% of acquired immune hemolytic anemia cases. These antibodies are a rare cause of interference in pretransfusion red blood cell (RBC) serologic testing. The aim of this work was to report three cases of subjects developing antibodies against co\u2010trimoxazole, a combination of trimethoprim (TMP) and sulfamethoxazole (SMX).<\/jats:p><jats:p><jats:bold>CASE REPORT AND METHODS:<\/jats:bold> Blood samples of donor\/patients were referred to our laboratory for the exploration of a positive antibody detection test. There was no recent history of drug taking. Antibody identification was performed by gel test using an indirect antiglobulin test, with reagent RBCs in low\u2010ionic\u2010strength solutions (LISS) containing co\u2010trimoxazole or not.<\/jats:p><jats:p><jats:bold>RESULTS:<\/jats:bold> All three sera showed positive reactions when RBCs were resuspended in LISS containing co\u2010trimoxazole, but negative reactions when RBCs were resuspended in LISS without antibiotic. We detected antibodies against co\u2010trimoxazole showing three different antibody patterns: anti\u2010TMP plus anti\u2010SMX, anti\u2010TMP alone, or anti\u2010SMX alone. Anti\u2010TMP showed an apparent anti\u2010Ku specificity in the two cases where it was present. Anti\u2010SMX showed an apparent anti\u2010H specificity in one of the two cases described. The drug\u2010dependent antibodies were not associated with acquired hemolytic anemia or other pathologies.<\/jats:p><jats:p><jats:bold>CONCLUSION:<\/jats:bold> Antibodies against co\u2010trimoxazole may only be detected when using a diluent for reagent RBCs containing the drug in question. Antibody pattern (anti\u2010TMP and\/or anti\u2010SMX) may vary according to individuals' immune response. Drug\u2010dependent antibodies may react as antibodies against a high\u2010prevalence antigen, supporting the hypothesis of antibodies to drug and membrane components. Drug\u2010dependent antibodies such as anti\u2010co\u2010trimoxazole may be a serologic finding without clinical features.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2011.03327.x","type":"journal-article","created":{"date-parts":[[2011,9,12]],"date-time":"2011-09-12T16:24:38Z","timestamp":1315844678000},"page":"844-848","source":"Crossref","is-referenced-by-count":8,"title":["Antibodies to co\u2010trimoxazole (trimethoprim and\/or sulfamethoxazole) related to the presence of the drug in a commercial low\u2010ionic\u2010strength 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