A CASE OF DRUG-INDUCED IMMUNE HEMOLYTIC ANEMIA DURING α-INTERFERON THERAPY FOR RENAL CELL CARCINOMA

Abstract

A Case of drug-induced immune hemolytic anemia during α-interferon (α-IFN) therapy for renal cell carcinoma is reported. A 61-year-old woman was admitted to Tochigi cancer center for the treatment of left renal cell carcinoma. She underwent left radical nephrectomy. From 7th post operative day, α-IFN (6×10⁶IU) was administered every other day. Diclofenac and indomethacin were administered for pain and high fever induced by α-IFN. Hemoglobinuria was first noted on 20th post operative day. Immune hemolytic anemia was suspected by blood examinations including Coombs' test, serum haptoglobin, serum LDH and serum GOT. α-IFN therapy and administration of diclofenac and indomethacin were discontinued and prednisolone therapy (50mg daily) was begun. Hemoglobinuria disappeared by 5 days and laboratory data became in normal range by 3 weeks. Drug-induced immune hemolytic anemia was diagnosed by the process of laboratory data, especially of direct Coombs' test. Though drug-induced immune hemolytic anemia is a rare adverse side effect during α-INF therapy for renal cell carcinoma, it seemed an important complication.