Two types of nomifensine-induced immune haemolytic anaemias: drug-dependent
sensitization and/or autoimmunization
by
Salama A, Mueller-Eckhardt C
Br J Haematol 1986 Nov; 64(3):613-20
ABSTRACT
Thirty-one patients who developed immune haemolytic anaemia while receiving
nomifensine were studied. We provide evidence that nomifensine can cause two
forms of immune haemolytic anaemia: one that is associated with an abrupt
haemolytic episode due to drug-dependent antibodies, and a less acute form
associated with IgG autoantibodies. The majority of patients' serum samples (23
cases) contained IgG and/or IgM antibodies reacting to a highly variable extent
with red blood cells (RBC) only in the presence of the drug and/or its
metabolites. Sera of six patients contained IgG autoantibodies which reacted,
like those in warm autoimmune haemolytic anaemia, with RBC in the absence of
drugs. Three patients had developed both types of antibodies. From a diagnostic
viewpoint, nine of the drug-dependent antibodies could not be identified by
using the drug itself, but by its known (three cases) or unknown urine-born
metabolites (ex vivo antigens). We conclude that nomifensine can induce in vivo
the production of RBC drug- and/or metabolite-dependent antibodies, autoantibodies, or both in the same patient.
Analgesia
Dopamine
Bupropion
Amineptine
Noradrenaline
Methylphenidate
Nomifensine dependence
Nomifensine versus imipramine
Hemolytic anemia: follow-up study
Nomifensine, bupropion and cocaine
Nomifensine, dopamine and noradrenaline
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