Massive Intravascular Haemolysis During Treatment With Nomifensine

Lylloff, Kirsten; Jersild, Casper; Bacher, Theis; Slot, Ole

doi:10.1016/s0140-6736(82)91171-0

Cited by 15 publications

(4 citation statements)

References 3 publications

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“…Drug-dependent antibodies of the immune complex type against RBC are usually IgM, with few reported exceptions (Packman & Leddy, 1983), and the DAT is only positive with anticomplement sera (Petz, 1980). This was true for the nomifensine antibody described by Lylloff et al(1982) as well as for ours. The buthiazide antibody, however, clearly was of the IgG class (subclass IgG1).…”

Section: Discussionsupporting

confidence: 80%

“…Although initial attempts to verify serologically the causative antibodies with in vitro antigen preparations of drugs failed, strongly positive results were obtained with the ex vivo antigens. Nomifensine, an antidepressant, has been incriminated as the cause of severe immune haemolysis in four reports (Bournerias & Habibi, 1979;Eckstein et al, 1981;Habibi et al, 1981;Lylloff et al, 1982). The technique of ex vivo antigen presentation has enabled us to demonstrate presumptive metabolite-specific antibodies against buthiazide and against nomifensine.…”

Section: Discussionmentioning

confidence: 99%

“…It is of interest that the present antibody did not crossreact with hydrochlorothiazide (or its ex vivo metabolites) which is related to Buthiazide and has been reported to cause immune haemolysis (Vila et al,1 9 76;Garratty et al,1 9 76). Nomifensine, an antidepressant, has been incriminated as the cause of severe immune haemolysis in four reports (Bournerias & Habibi, 1979;Eckstein et al, 1981;Habibi et al, 1981;Lylloff et al, 1982). In all these cases the antibodies were reported as having caused agglutination but no haemolysis of normal or enzyme-treated RBC in the presence of the drug.…”

Section: Discussionmentioning

confidence: 99%

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Ex vivo antigen preparation for the serological detection of drug‐dependent antibodies in immune haemolytic anaemias

et al. 1984

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Two patients with severe, intravascular haemolysis due to drug-dependent antibodies are described. The antibodies were directed against presumptive metabolites of buthiazide (International Non-proprietary Name, butizide) and nomifensine. Their detection was possible only in the presence of ex vivo antigens (i.e. fresh serum of volunteers after ingestion of the drugs) while in vitro antigen preparations yielded inconclusive results. Both antibodies lysed normal red cells in the presence of ex vivo antigens and complement. The buthiazide-related antibody was IgG (subclass IgG1), the nomifensine-related antibody was IgM. We conclude that the use of ex vivo antigens is of great importance in the serological evaluation of cases with suspected drug-dependent immune haemolysis.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ex vivo antigen preparation for the serological detection of drug‐dependent antibodies in immune haemolytic anaemias

et al. 1984

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“…Abnormal results of liver function tests and, less frequently, fever alone or associated with joint pain or rash, have been occasionally observed (1). More recently, 4 cases of immune hemolytic anemia have also been reported (2)(3)(4). We report here a case of a woman who developed a lupus-like syndrome following the administration of nomifensine, and the syndrome's disappearance upon dechallenge.…”

Section: Lupus-like Syndrome During Treatment With Nomifensinementioning

confidence: 80%

Lupus‐like syndrome during treatment with nomifensine

García-Morteo¹,

Maldonado‐Cocco²

1983

Arthritis & Rheumatism

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Second Generation Antidepressants: A Comparative Review

Coccaro

Siever

1985

The Journal of Clinical Pharma

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The authors review four "second generation" antidepressants (maprotiline, amoxapine, trazodone, and nomifensine) in terms of action on biogenic amines and receptors, antidepressive efficacy, and adverse effects. Doxepin is used as a comparative agent and is similar to the prototypical tricyclic agents in all the above categories. Maprotiline is a selective noradrenergic agent, but shares a similar adverse effect profile with doxepin and may be associated with a high frequency of seizures in overdose. Amoxapine is a mixed action antidepressant with significant neuroleptic activity in vivo. Its adverse effect profile is highlighted by symptoms related to its neuroleptic activity, and seizures and acute renal failure in overdose. Trazodone is a selective serotonergic agent with low anticholinergic activity, and minimal morbidity/mortality in overdose. Reports of priapism, leading to impotence in some men, however, is of concern. Nomifensine is a potent noradrenergic and dopaminergic agent with low anticholinergic activity, and minimum cardiotoxicity and low morbidity/mortality in overdose. Its most important adverse effects include overstimulation and infrequent, usually reversible, immunologic hypersensitivity reactions. Trazodone and nomifensine have favorable profiles for use in the elderly. Trazodone may be more favorable in the anxious/agitated patient due to its sedative effects, whereas nomifensine may be more beneficial in the retarded, apathetic patient.

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Massive Intravascular Haemolysis During Treatment With Nomifensine

Cited by 15 publications

References 3 publications

Ex vivo antigen preparation for the serological detection of drug‐dependent antibodies in immune haemolytic anaemias

Ex vivo antigen preparation for the serological detection of drug‐dependent antibodies in immune haemolytic anaemias

Lupus‐like syndrome during treatment with nomifensine

Second Generation Antidepressants: A Comparative Review

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