2016 Volume 65 Issue 1 Pages 51-54
A 67-year-old male was admitted to our hospital in November 2011 for treatment of hepatocellular carcinoma (HCC). He was repeatedly hospitalized owing to HCC recurrence. During this time, early gastric carcinoma and esophageal varix were also found and he had Helicobacter pylori eradication therapy. Ten months after the eradication therapy, in May 2013, severe anemia (Hb level, 6.9 g/dL) due to upper gastrointestinal hemorrhage was observed; thus, blood transfusion was carried out. Detailed examination was carried out after the screening for antibodies revealed this time positive results. He had warm-reactive irregular antibodies, and a direct antiglobulin test revealed the existence of anti-erythrocyte antibodies. Furthermore, the haptoglobin level was < 10 mg/dL. Given all these symptoms, his condition was considered to be autoimmune hemolytic anemia in addition to upper gastrointestinal hemorrhage. We studied the critical causes of all the symptoms. We found that in the past, he had allergic reactions to Takepron, such as rubefaction; thus, he stopped taking it. During the Helicobacter pylori eradication therapy, he took Lansap, which contains Takepron; after which, his hemoglobin level decreased. Later on, Takepron was not administered and his anemia gradually improved. Twenty months after taking Lansap, both direct and indirect antiglobulin tests showed negative results. On the basis of the above findings, this case was considered to be Takepron-induced autoimmune hemolytic anemia.
