Author(s)

Mamadou Cellou Balde^1*, Mamadou Saliou Balde², Alpha Boubacar Bah², Mamadou Falilou Diallo³, Ibrahim Cherif², Luciana Spataru¹, Zeinab Awada¹, Laetitia Caumette⁴, Marie Annick Cadeac⁴, Bernard Delmas⁴, Philippe Montane De La Roque⁵, Joséphine Thomazeau⁵, Algassimou Bah², Mamadou Sere Bah⁶, Mohamed Lamine Kaba², Alpha Oumar Bah²

¹Nephrology Department, Inter-Municipal Hospital Center in the Ariège Valleys, Ariège, France.
²Department of Nephrology-Hemodialysis, Donka University Hospital Center, Conakry, Guinée.
³Nephrology Department, Hospital Group of Havre, Havre, France.
⁴Intrahospital Pharmacy Service in Val d’Ariege, Ariége, France.
⁵Internal Medicine Department, Intercommunal Hospital Center of the Ariège Valleys, Ariège, France.
⁶Longjumeau Hospital Center, General Medicine Department, Longjumeau, France.

The occurrence of acute hemolysis in a patient with stable hemoglobinosis can be of corpuscular or extra-corpuscular origin. We report the case of a patient with sickle cell disease SS stable for twenty years, who is treated with levofloxacin for sepsis with a urinary starting point. Biology: hyperleukocytosis at 33,570/mm3 made up of 90% neutrophils and CRP at 160 mg/l, hemolytic, mechanical, nonthrombocytic microcytic anemia (Hb at 8.3 g/dl, VGM at 70 μm3, haptoglobulin collapsed < 0.1, weakly positive schistocytes < 0.1%, PL at 277,000 with no evidence for DIC, the fibrinogen level is rather high at 5.68 g/l and hemostasis is normal. blood ionogram, renal function is normal with blood urea at 4 mmol/l and creatinine at 62 μmol/l. The rest of the blood ionogram are normal apart from the proteins which are contracted at 93 g/l. The liver test shows a Bilirubin total at 144 UI/L, Conjugated bilirubin at 38 UI/L, Free Bilirubin at 106 UI/L, PAL at 166, ASAT and ALAT at 50 UI/L, GGT, Amylase are normal. The iron balance is rather inflammatory with low serum iron at 8 μmol/l, saturation at 13% and high serum ferritin at 462 μg/l ECBU comes back positive for entero bacter chloacae with significant leukocyturia at more than 100,000/ml associated with hematuria at 25,000/ml complicated by bacteremia with the same germ. The evolution is marked by the persistence of haemolytic signs despite the regression of inflammatory markers. Levlofloxacin unmasks a G6PD deficiency. The substitution of levolofloxacin by cefixime allows a clear clinical and biological improvement.

Hemolysis, Sickle Cell Disease, G6PHD, Levofloxacin, Prostatitis

Balde, M.C., Balde, M.S., Bah, A.B., Diallo, M.F., Cherif, I., Spataru, L., Awada, Z., Caumette, L., Cadeac, M.A., Delmas, B., De La Roque, P.M., Thomazeau, J., Bah, A., Bah, M.S., Kaba, M.L. and Bah, A.O. (2023) Hemolysis Supported by Levofloxacin in an SS Sickle Cell Patient. Open Access Library Journal, 10, 1-5. doi: 10.4236/oalib.1110193.