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Anemia hemolítica inmunitaria inducida por medicamentos - Overview

Nombres alternativos

Anemia hemolítica inmunitaria secundaria a medicamentos; Anemia hemolítica inmunitaria secundaria a fármacos

Definición:

Es un trastorno sanguíneo que ocurre cuando un medicamento activa el sistema de defensa del cuerpo (sistema inmunitario) para atacar a sus propios glóbulos rojos. Esto hace que los glóbulos rojos se descompongan más temprano de lo normal, un proceso llamado hemólisis.

Ver también: anemia hemolítica.

Causas:

En algunos casos, un medicamento puede hacer que el sistema inmunitario crea erróneamente que los glóbulos rojos son sustancias extrañas y peligrosas. En consecuencia, se forman anticuerpos contra los glóbulos rojos. Dichos anticuerpos se adhieren a estos glóbulos rojos y hacen que se descompongan demasiado temprano.

Dentro de los fármacos que pueden causar este tipo de anemia hemolítica están:

  • Cefalosporinas (un tipo de antibióticos), los más comunes.
  • Dapsona.
  • Levodopa.
  • Levofloxacina.
  • Metildopa.
  • Nitrofurantoína.
  • Algunos antinflamatorios no esteroides (AINES).
  • Penicilinas y sus derivados.
  • Fenazopiridina (pyridium).
  • Quinidina.

Existen muchas otras causas raras de anemia hemolítica inducida por medicamentos. Esto incluye a la anemia hemolítica asociada con la deficiencia de glucosa -6 fosfato deshidrogenasa (G-6-PD). En este caso, la descomposición de los glóbulos rojos se debe a cierto tipo de estrés en la célula y no al sistema inmunitario del cuerpo.

La anemia hemolítica inducida por medicamentos es rara en niños.

  • Reviewed last on: 2/28/2011
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Powers A, Silberstein LE. Autoimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr., Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2008:chap 47.

Schrier SL, Price EA. Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ Jr., Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2008:chap 48.

Schwartz R. Autoimmune and intravascular hemolytic anemia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 164.

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