Cefotaxime‐induced immune hemolytic anemia due to antibodies reacting in vitro by more than one mechanism

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Abstract
Until recently, all cephalosporin‐induced immune hemolytic anemias appeared to react by a “penicillin‐type” drug adsorption mechanism, and hemolysis was extra‐vascular. In 1987 and 1988, the first two cases of cephalosporin‐induced immune hemolytic anemia with intravascular hemolysis associated with a so‐called immune complex mechanism were reported. This report describes a case of extravascular hemolysis due to a third‐generation cephalosporin, cefotaxime, which, to the authors' knowledge, is the first to show in vitro characteristics of both the drug adsorption and the so‐called immune complex mechanisms.