{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:32:46Z","timestamp":1769128366317,"version":"3.49.0"},"reference-count":7,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T00:00:00Z","timestamp":1548892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Drug\u2010induced hemolytic anemia is a rare and potentially fatal complication of drug treatment. Specific laboratory tests are crucial to confirm the diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CASE REPORT<\/jats:title><jats:p>A 38\u2010year\u2010old woman on treatment with dimethyl fumarate for multiple sclerosis presented with a 7\u2010day history of weakness and fatigue. Laboratory tests revealed profound hemolytic anemia with hemoglobin levels of 4.7 g\/dL (reference, 12.5\u201316.0), decreased haptoglobin, increased reticulocyte count, and increased indirect bilirubin. A first direct antiglobulin test was negative. The patient was started on prednisone 1 mg\/kg\/day, and dimethyl fumarate was withdrawn. A blood sample was drawn on Day 7 and sent to a reference laboratory. A direct antiglobulin test performed 7 days later was positive. Furthermore, an indirect antiglobulin test was positive only in the presence of the drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The patient did not receive a blood transfusion, recovered clinically during the following days, and was discharged on Day 7. On Day 36, the patient's RBCs had normalized. She was changed to another disease\u2010modifying treatment for her multiple sclerosis, and at 10\u2010month follow\u2010up she remained stable without any notable adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>This case describes the first report of a dimethyl fumarate\u2013induced hemolytic anemia. Laboratory results should always be interpreted within the clinical context. Specific laboratory expertise is often needed, given the complexity of the field.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15151","type":"journal-article","created":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T14:03:33Z","timestamp":1548943413000},"page":"1648-1650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The first reported case of drug\u2010induced hemolytic anemia caused by dimethyl fumarate in a patient with multiple sclerosis"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4681-2456","authenticated-orcid":false,"given":"Carlos","family":"Quintanilla\u2010Bord\u00e1s","sequence":"first","affiliation":[{"name":"Department of Neurology Consorci Hospital General Universitari de Valencia, Neurology  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Castro\u2010Izaguirre","sequence":"additional","affiliation":[{"name":"Centro de Transfusi\u00f3n de la Comunidad Valenciana Conselleria de Sanitat  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Carcel\u00e9n\u2010Gadea","sequence":"additional","affiliation":[{"name":"Department of Neurology Consorci Hospital General Universitari de Valencia, Neurology  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"Department of Hematology Consorci Hospital General Universitari de Valencia  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tracli.2017.05.013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.21307\/immunohematology-2019-101","article-title":"Diagnostic pitfalls of drug\u2010induced immune hemolytic anemia","volume":"30","author":"Salama A","year":"2014","journal-title":"Immunohematology"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000440673"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1984.tb01564.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2005.04.005"},{"key":"e_1_2_9_7_1","volume-title":"Immune hemolytic anemias","author":"Petz LD","year":"2004"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2004.02145.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftrf.15151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:15:04Z","timestamp":1694362504000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.15151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,31]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/trf.15151"],"URL":"https:\/\/doi.org\/10.1111\/trf.15151","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,31]]},"assertion":[{"value":"2018-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}