Vancomycin-induced immune hemolytic anemia: a case report and literature review.

Drug-induced immune hemolytic anemia (DIIHA) is a rare but potentially life-threatening adverse drug reaction. Although more than 150 drugs have been reported to induce DIIHA, vancomycin, a glycopeptide antibiotic widely used in clinical practice, is rarely associated with hemolysis, making it prone to underdiagnosis or misdiagnosis. This article reports a case of vancomycin-induced DIIHA in a 64-year-old female patient after right revision knee arthroplasty (RKA). This study investigated the serological tests associated with vancomycin and tracks drug antibody titers through longitudinal monitoring during clinical diagnosis and treatment. Additionally, a literature review identified and summarized five previously reported cases of vancomycin-induced immune hemolytic anemia. Clinicians should maintain a high index of suspicion for hemolysis associated with vancomycin, including its use in bone cement. Early recognition, prompt withdrawal of the offending agent, and transfusion support are imperative for improving patient outcomes with DIIHA.