Antibodies form against the red blood cells.
The antibodies combine with the affected red blood cells and result in their premature destruction. The incidence is rare in children. Drugs that can cause secondary immune hemolytic anemia are penicillins, cephalosporins, levodopa , methyldopa, mefenamic acid , quinidine , salicylic acid , sulfonamides, Thiazide diuretics , antazoline, chlorpromazine, isoniazid , streptomycin , and Motrin . Drug-induced hemolytic anemia is most often associated with G6PD deficiency . A direct Coombs' test is positive.