A female patient on Fluorouracil (5-FU) therapy for rectal carcinoma developed acute intravascular haemolysis with her fifteenth drug injection; a similar episode occurred later after a controlled challenge with the drug. A 5-FU-dependent complement-activating IgM antibody, which reacted with RBC in an indirect antiglobulin test, was detected in her serum. The antibody did not react with cord RBC, but a blood group specificity could not be determined. An excess of 5-FU in the indirect antiglobulin tests resulted in inhibition of these reactions.
A female patient developed serious hemolysis in association with the injection of a radiographic contrast medium (RCM). Serologic investigation of her serum suggested complement-mediated hemolysis, induced by an RCM-dependent IgM antibody in her serum. The antibody was of high titer and low avidity. The antibody showed cross-reactions with related radiographic contrast media and reacted only with group I adult RBCs.
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