Abstract: Objective To investigate immune hemolytic anemia induced by ceftizoxime sodium, focusing on its serological characteristics and clinical diagnostic approaches. Methods A patient who developed immune hemolytic anemia following ceftizoxime sodium administration in April 2024 was enrolled. Serological tests, including the direct antiglobulin test (DAT), serum antibody screening, elution testing, drug-dependent antibody detection, and in vitro hemolysis assays, were done to identify drug-specific antibodies. Results The patient's DAT results were positive for anti-IgG and anti-C3d. Serum antibody screening showed pan-reactivity, while elution tests were negative. Drug-dependent IgM (titer 32) and IgG (titer 16) antibodies specific to ceftizoxime sodium were confirmed. In vitro experiments revealed that these antibodies induced erythrocyte hemolysis in the presence of calcium ions and complement. Conclusion Ceftizoxime sodium activates complement through an immune complex mechanism, leading to acute intravascular hemolysis. Rapid recognition of drug-induced immune hemolytic anemia (DIIHA), establishment of standardized laboratory protocols for detecting drug-dependent antibodies, and immediate discontinuation of the sensitizing drug are critical for effective clinical management.

Key words: Ceftizoxime sodium, Immune hemolytic anemia, Serological techniques, Drug dependent antibodies