{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T21:10:06Z","timestamp":1768425006537,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T00:00:00Z","timestamp":1505347200000},"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":[[2017,12]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Drug\u2010induced immune hemolytic anemia (DIIHA) and drug\u2010induced immune thrombocytopenia (DIIT) are rare but dangerous complications of pharmacotherapy that may be underrecognized in hematopoietic stem cell transplant (HSCT) patients due to overlap of signs and symptoms with those of more common disease processes.<\/jats:p><\/jats:sec><jats:sec><jats:title>CASE REPORT<\/jats:title><jats:p>A 61\u2010year\u2010old woman with NK\u2010cell deficiency and GATA\u20102\u2013associated myelodysplastic syndrome, status post\u2013recent allogeneic HSCT (Day +58), presented with 3 days of acute\u2010onset severe back pain, muscle cramps, and increasingly dark urine. She was found to be anemic, thrombocytopenic, and in acute renal failure. On admission, the direct antiglobulin test was positive for complement (C3) only. After careful review of her medication list, the possibility of DIIHA was raised. She had started taking trimethoprim\u2010sulfamethoxazole (TMP\u2010SMX) for <jats:italic>Pneumocystis jiroveci<\/jats:italic> pneumonia prophylaxis 24 days prior on a weekend dose schedule. Serologic tests on peripheral blood samples were performed using standard methods. Drug studies were performed at an immunohematology reference laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The patient's serum showed hemolysis of donor red blood cells in the presence of TMP\u2010SMX and also TMP\u2010SMX\u2013induced platelet antibodies. The patient was treated with transfusions, hemodialysis, and immunosuppressive agents. Her clinical condition improved and she was discharged after 8 days in stable condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>This case describes the first reported concurrent DIIHA and DIIT due to TMP\u2010SMX\u2013induced antibodies in an HSCT patient. DIIHA and DIIT can present a diagnostic challenge in the setting of intermittent medication dosing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14315","type":"journal-article","created":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T07:28:24Z","timestamp":1505374104000},"page":"2937-2941","source":"Crossref","is-referenced-by-count":11,"title":["The first reported case of concurrent trimethoprim\u2010sulfamethoxazole\u2013induced immune hemolytic anemia and thrombocytopenia"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2413-433X","authenticated-orcid":false,"given":"Yevgeniy A.","family":"Linnik","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edison W.","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella W.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zbigniew M.","family":"Szczepiorkowski","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"},{"name":"Department of Medicine, Geisel School of Medicine Dartmouth College Hanover New Hampshire"},{"name":"Institute of Hematology and Transfusion Medicine Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-1679","authenticated-orcid":false,"given":"Gregory A.","family":"Denomme","sequence":"additional","affiliation":[{"name":"Diagnostic Laboratories and Blood Research Institute, BloodCenter of Wisconsin Milwaukee Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerome L.","family":"Gottschall","sequence":"additional","affiliation":[{"name":"Diagnostic Laboratories and Blood Research Institute, BloodCenter of Wisconsin Milwaukee Wisconsin"},{"name":"Department of Pathology Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"John M.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Medicine, Geisel School of Medicine Dartmouth College Hanover New Hampshire"},{"name":"Blood and Marrow Transplant Program Norris Cotton Cancer Center Hanover New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy M.","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"},{"name":"Department of Medicine, Geisel School of Medicine Dartmouth College Hanover New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.21307\/immunohematology-2019-098","article-title":"Drug\u2010induced immune hemolytic anemia: the last 30 years of changes","volume":"30","author":"Arndt PA.","year":"2014","journal-title":"Immunohematology"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra066469"},{"key":"e_1_2_6_4_1","first-page":"760","article-title":"Studies on the mechanism of a drug\u2010induced hemolytic anemia","volume":"47","author":"Harris JW.","year":"1956","journal-title":"J Lab Clin Med"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-100"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340000598"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14654"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03360.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199409000-00019"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1987.27387235635.x"},{"key":"e_1_2_6_11_1","first-page":"3190","article-title":"Acute hemolytic anemia in liver and bone marrow transplant patients under FK 506 therapy","volume":"23","author":"Abu\u2010Elmagd KM","year":"1991","journal-title":"Transplant Proc"},{"key":"e_1_2_6_12_1","first-page":"282","article-title":"Tacrolimus\u2010related posttransplant lymphoproliferative disorder presenting as autoimmune hemolytic anemia","volume":"120","author":"DiGiuseppe JA","year":"1996","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-3274(96)80015-3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(02)03816-2"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2005.00460.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01304.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05809.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2007.00619.x"},{"key":"e_1_2_6_19_1","first-page":"267","article-title":"Pneumocystis carinii pneumonitis following bone marrow transplantation","volume":"10","author":"Tuan IZ","year":"1992","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.06.019"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199711000-00004"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080558"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462414567547"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.1995.tb04378.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.2.218"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3148.2010.01061.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftrf.14315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.14315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T05:54:20Z","timestamp":1694757260000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.14315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,14]]},"references-count":25,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/trf.14315"],"URL":"https:\/\/doi.org\/10.1111\/trf.14315","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,14]]}}}