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

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Ceftriaxone-induced hemolytic crisis is a rare and severe adverse reaction requiring immediate drug discontinuation.
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A 57-year-old woman developed a ceftriaxone-induced hemolytic crisis characterized by dark brown urine and a sharp decline in hemoglobin.
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Whole blood exchange–lymphoplasmapheresis combined transfusion (WLCT) was successfully used to treat the patient's hemolytic crisis.
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Post-treatment, the patient's hemolysis, liver function, and antibody titers improved, with a negative direct Coombs test.
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This case represents the first successful application of WLCT for ceftriaxone-induced hemolytic crisis, warranting further study.

Frontiers In Immunology

by Na Shen, Mu Zhang, Jingwei Li, Hongyan Chen, Yan Xing, Wenjun Que, Xiaoliang Yang
July 9, 2026

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