D59.2
Drug-induced nonautoimmune hemolytic anemia
Clinical Classification Guidelines
Use Additional Code
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Inclusion Terms
- Drug-induced enzyme deficiency anemia
Medical Intelligence & Overview
Drug-induced nonautoimmune hemolytic anemia is a rare condition where certain medications cause the destruction of red blood cells, leading to hemolytic anemia. Unlike autoimmune types, this form does not involve the immune system attacking the body's own cells. Instead, the hemolysis occurs due to the medication's effect on enzymes within red blood cells, resulting in their premature destruction. Recognized by the ICD-10 code D59.2, this condition can vary in severity and may be reversible once the causative drug is discontinued.
Causes & Symptoms
Clinical Causes: Use of specific drugs such as certain antibiotics, including penicillins and cephalosporins Consumption of medications like phenacetin or quinine Chronic use of some non-steroidal anti-inflammatory drugs (NSAIDs) Exposure to certain antimalarial drugs such as primaquine or quinidine Use of some antipsychotic medications
Key Symptoms: Fatigue and weakness due to decreased oxygen delivery Pale or jaundiced skin resulting from anemia and increased bilirubin Dark-colored urine indicating hemoglobin breakdown Shortness of breath or rapid heartbeat Fever and chills in some cases Enlarged spleen or liver in more severe cases
Diagnostic & Treatment
Diagnosis Path: The diagnosis typically involves a combination of patient history, physical examination, and laboratory tests. Key steps include: - Blood tests to measure hemoglobin and hematocrit levels, identifying anemia. - Peripheral blood smear to observe red blood cell morphology. - Coombs test (direct antiglobulin test) to distinguish between autoimmune and nonautoimmune hemolytic anemia (usually negative in drug-induced cases). - Look for elevated bilirubin and lactate dehydrogenase (LDH) levels indicating increased red blood cell breakdown. - Assessing recent medication history to identify potential causative drugs. - Additional tests such as enzyme activity assays may be performed to detect enzyme deficiencies caused by medication effects.
Treatment Protocols: Managing drug-induced nonautoimmune hemolytic anemia primarily involves identifying and stopping the offending medication. Supportive treatments include: - Blood transfusions in severe anemia cases to restore red blood cell levels. - Close monitoring of blood counts and symptoms. - Monitoring for any complications related to anemia or hemolysis. - Alternative medications may be recommended to avoid recurrence. - In some cases, corticosteroids are not effective since the condition is not immune-mediated, but supportive care remains essential. - Once the causative drug is discontinued, most patients experience improvement as red blood cell production recovers. - Follow-up testing to confirm the resolution of hemolysis.
Clinical Advice & FAQs
Billing Guidance
Is D59.2 a billable ICD-10 code?
Yes, D59.2 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report D59.2?
Clinical documentation must specify the nature of Drug-induced nonautoimmune hemolytic anemia and any associated comorbidities for accurate reporting.
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