First application of whole blood exchange–lymphoplasmapheresis combined transfusion for restoring immune homeostasis of ceftriaxone-induced hemolytic crisis: a case report - Report - MDSpire

First application of whole blood exchange–lymphoplasmapheresis combined transfusion for restoring immune homeostasis of ceftriaxone-induced hemolytic crisis: a case report

  • By

  • Na Shen

  • Mu Zhang

  • Jingwei Li

  • Hongyan Chen

  • Yan Xing

  • Wenjun Que

  • Xiaoliang Yang

  • July 9, 2026

  • 0 min

Share

Clinical Report: Innovative Use of Combined Whole Blood Exchange and Lymphoplasmapheresis Transfusion

Background

Ceftriaxone-induced hemolytic crisis is a rare but severe adverse reaction that can lead to rapid hemolysis and organ failure. Immediate cessation of the drug is critical, yet some patients may still face fatal outcomes.

Data Highlights

No numerical data or trial data available in the article.

Key Findings

  • A 57-year-old woman developed a ceftriaxone-induced hemolytic crisis characterized by a rapid decline in hemoglobin levels.
  • The patient exhibited a positive direct Coombs test and elevated antibody titers against ceftriaxone.
  • Whole blood exchange combined with lymphoplasmapheresis transfusion led to significant clinical improvement.
  • The direct Coombs test became negative post-treatment, indicating restored immune balance.
  • The patient was discharged after 10 days and remained stable during a 3-month follow-up.

Clinical Implications

The application of whole blood exchange and lymphoplasmapheresis transfusion in this case may provide a therapeutic option for managing ceftriaxone-induced hemolytic crises.

Conclusion

This case highlights the application of combined transfusion strategies in treating severe drug-induced hemolytic crises.

Related Resources & Content

  1. British Society for Haematology, BSH Guidelines, 2023 -- Management of Drug-Induced Immune and Secondary Autoimmune Hemolytic Anemia
  2. American Society for Apheresis, ASFA Guidelines, 2023 -- Therapeutic Apheresis in Clinical Practice
  3. Intensive Care Medicine — Facilitating Transplantation for Patients with Acute-on-Chronic Liver Failure: The Role of Plasma Exchange in Managing Multiorgan Dysfunction
  4. Intensive Care Medicine — Exploring the Role of Extracorporeal Blood Purification in Restoring Homeostasis During Sepsis: A Critical Analysis of Recent Findings
  5. Critical Care (Springer) — Severe autoimmune hemolytic anemia in ICU: a place for emergency plasma exchange? A French multicenter retrospective study
  6. Critical Care (Springer) — Therapeutic target of high fresh frozen plasma to red blood cell ratio in severe blunt trauma
  7. Facilitating Transplantation for Patients with Acute-on-Chronic Liver Failure
  8. Exploring the Role of Extracorporeal Blood Purification in Sepsis
  9. Severe Autoimmune Hemolytic Anemia in ICU: A Place for Emergency Plasma Exchange?
  10. Structure of guideline
  11. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue - PubMed

Original Source(s)

First application of whole blood exchange–lymphoplasmapheresis combined transfusion for restoring immune homeostasis of ceftriaxone-induced hemolytic crisis: a case report

  • by Na Shen, Mu Zhang, Jingwei Li, Hongyan Chen, Yan Xing, Wenjun Que, Xiaoliang Yang

  • July 9, 2026

Related Content

Case Report: Pediatric Philadelphia chromosome-positive T-lymphoblastic leukemia relapsing as chronic-phase CML after treatment discontinuation

Rather a versatile multi-tool than a sword: an integral role of the plasminogen system in health and disease

Assessing the risk of adverse drug events from combining aromatase inhibitors with CDK4/6 inhibitors using the FAERS and JADER databases