(Aiha)

Key points

• Certain anti-tuberculous drugs (e.g. rifampicin, isoniazid) can trigger drug-induced immune haemolytic anaemia, sometimes via an immune-complex mechanism
• Presentation can include sudden dyspnoea, syncope, lethargy and dizziness, developing over days to weeks after starting the causative drug
• Management: stop the offending drug, give supportive care, consider steroids if haemolysis is severe