Vancomycin-induced Immune Hemolytic Anemia – A case report and literature review

Drug-induced immune hemolytic anemia (DIIHA) is a rare complication of drug treatment. The clinical presentation involves rapid dropping of hemoglobin secondary to hemolysis leading to potentially fatal consequences. Over 100 drugs have been reported to cause DIIHA, most commonly cephalosporins. Here, we present a case of vancomycin-induced immune hemolytic anemia. The diagnosis was challenging due to the limited reports of hemolytic anemia induced by vancomycin in the setting of multiple antibiotic administration history. Hemolysis improved after vancomycin cessation and diagnosis was made with positive serological confirmation. Literature review was performed with four reported cases of vancomycin-induced immune hemolytic anemia identified and summarized. Our goal is to promote awareness of vancomycin as an uncommon cause of DIIHA for better management in clinical practice.