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Cianidanol, also known as (+)-catechin; (+)-3,3′4′,5,7-flavanepentol; 3,3′,4′, 5,7-pentahydroxyflavane, [R,3S]-2-[3,4-dihydroxyphenyl]-3,4-dihydro-1[2H]- benzopyran-3,4,7-triol, or 2-(3,4-dihydroxyphenyl)-3,4-dihydro-(2r-trans)-2h- 1-benzopyran-7-triol, is a flavonoid associated with a variety of blood disorders. An association of cianidanol and immune hemolytic anemia and thrombocytopenia has been suggested in numerous case reports. In several reports, the presence of flavonoid-dependent antibodies against red blood cells is evident with cianidanol combining with erythrocyte membranes and inducing development of autoantibodies and antibodies.Several patients had platelet antibodies with increased serum-bindable IgG values without the presence of cianidanol and several with high platelet-associated IgG levels.Antibodies against cianidanol were not detectable in certain cases.The hemolytic anemia caused acute renal failure in some patients and can be life threatening, leading to fatalities. Upon cessation of treatment with cianidanol, hematology appears to return to normal over time.
These side effects do not appear to be specific to cianidanol as the formation of IgE and IgG antibodies to troxerutin (Venoruton) and silymarin (Kegalon) was also evident with patients presenting with fever, skin eruptions, and intravascular hemolysis often demonstrating high IgG titers.Furthermore, cianidanol-induced hemolysis might also occur after sensitization by other flavonoids including rutin.
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