Hemolytic anemia caused by penicillin. Report of a case in which antipenicillin antibodies cross-reacted with cephalothin sodium

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Abstract
Following the administration of ampicillin sodium, methicillin sodium, and penicillin G sodium to a patient with broncho-pneumonia a direct Coombs'' test was positive and hemolytic anemia developed. The patients'' indirect Coombs'' test was positive with group O erythrocytes previously incubated with penicillin G, ampicillin, methicillin, or cephalothin sodium. Adsorption of his serum with penicillin-treated erythrocytes reversed the positive reaction to the indirect Coombs'' test with both penicillin-treated and cephalothin -treated erythrocytes. Eluates prepared from erythrocytes, which had been treated with either penicillin G or cephalothin and incubated with his serum, gave a positive indirect Coombs'' test with penicillin-treated and with cephalothin-treated erythrocytes. The half-life of autologous erythrocytes treated with penicillin G and sodium chromate Cr 51 was less than 40 min. Although the patient had never received cephalothin before, the halflife of autologous cephalothin-treated erythrocytes was 135 min.