When certain drugs that are not toxic to the majority of the population are given to a few sensitive persons, marked hemolytic anemia occurs. Three distinct types of mechanism that render red cells sensitive to drug-induced hemolysis have been delineated. A lack of certain enzymes, which serve to maintain glutathione in the reduced form or which synthesize glutathione, renders the cell sensitive to hemolysis by a group of "oxidant" drugs. Abnormalities in the globin portion of the hemoglobin molecule affecting either the alpha or beta chain near the site of the attachment of heme give rise to instability of hemoglobin and result in sensitivity to the hemolytic effect of the same group of drugs. Finally, immunologic mechanisms of three separate types have been implicated in sensitivity to drugs. In such persons antibodies develop in response to either a normal red cell component or to a drug-red cell complex and this leads to premature destruction of the red cell.
- 1969 by The Williams & Wilkins Co.