Immunologic findings in patients receiving methyldopa: a prospective study.

Abstract

Abstract Among 71 hypertensive patients (33 Caucasian, 38 Negro) treated with methyldopa, 15 had positive direct antiglobulin (Coombs) tests. Four of these were of the IgG type, and all 4 occurred in Caucasian patients who had low levels of acetyl transferase. Eleven were of the non-IgG (complement) type and were observed in both Negro and Caucasian patients. None of the positive antiglobulin reactions was associated with changes in plasma hemoglobin levels or hemoglobin-binding capacities suggestive of hemolysis. Varied immunologic abnormalities outside the erythrocyte autoantibody system were also noted. ANA (autinuclear antibodies) were present in 53 per cent of the tested patients, elevated levels of IgG, IgA, or IgM immunoglobulins in 46 per cent, rheumatoid factor in 18 per cent, and LE cells in 4 per cent. Fourteen patients had typical and 2 had possible atypical hydralazine toxicity before or during treatment with methyldopa. Eight of them had positive antiglobulin tests, and for 3 they were of the IgG type. All of the hydralazine-toxic patients had ANA, and two thirds of them had elevated levels of IgG, IgA, or IgM immunoglobulins.