AIM: To explore the pathogenic mechanism of acute
hemolysis and renal failure induced by puerarin. METHODS: Antiglobulin
test (AGT) of drug simulated in vitro were performed with hemo immunology. Blood samples were taken at d 1, d 8 and 8 mo of the onset. The immune complex on
patient cell(Pc) was detected with direct antiglobulin test(DAT). Whether agglutination or hemolysis occurred was determined with indirect antiglebulin test (IAT) when the donor blood cell (Dc) incubated with patient
serum (Ps), puerarin in normal saline (NS) media and antiglobulin serum(AGS). RESULTS: In DAT——Pc was positive. In IAT——Dc incubated Dc with Ps, would agglutinate strongly in NS media, but partly occur hemolysis in wash. Dc agglutinated with broad spectrum anti globulin serum and anti complement(C 3) stronger than with anti IgG serum. Dc
didn't agglutinate when only incubated with pueranrin. Ps without pueranrin didn't aggluinate, nor did Dc with pueranrin. The agglutination didn't exist for Pc and Ps when repeated the above test after 8 mo. CONCLUSION: IgM, Anti puerarin antibody, which activating the complement exists in the patient's serum. It is the pathologic basis causing acute intravascular hemolysis and renal failure.