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Abinaya Seenivasan

Lister Hospital, United Kingdom

Title: Those that can heal, can harm”- Ceftriaxone induced haemolysis in children with Sickle cell Disease

Biography

Biography: Abinaya Seenivasan

Abstract

Objectives: To analyze the incidence of Ceftriaxone Induced Immune Hemolytic Anemia (CIIHA) in pediatric population and its significance among various genotypes of Sickle cell Disease (SCD).
Methods: We performed a single-centered retrospective study for 5 years on ceftriaxone induced hemolysis in SCD population who were in our data base. Pre and post hemoglobin levels following intravenous Ceftriaxone was analyzed. The duration of antibiotics and its effect in different SCD genotypes were studied.
Results: We had 60 admissions among 26 patients and 58 admissions received more than 1 dose of ceftriaxone. The pre- and post-ceftriaxone hemoglobin levels were 85.5 and 83.7 mg/dl respectively. The hemoglobin values post ceftriaxone in HbSS and HbSC genotypes did not show any difference. Despite receiving 10 doses of ceftriaxone none of them showed acute clinical deterioration.
Discussion: Increasing case reports on CIIHA in children with SCD causes wariness of using the most preferred antibiotic.  As actual incidence of CIIHA remains unknown, we retrospectively analyzed the effect of ceftriaxone in children with SCD. Among 60 admissions none of them showed clinical deterioration and the pre and post ceftriaxone hemoglobin levels were similar. The number of doses did not have any effect on the hemoglobin levels. There were no appreciable differences in hemolysis between the HbSS and HbSC groups. 
Conclusion: Although the complication of CIIHA should be borne in mind, it should not be a limiting factor to offer ceftriaxone and would be premature to defer in the SCD population. Larger multi-centric trials are required to understand the actual incidence of CIIHA in paediatric population.