Recurrent hyperhemolytic transfusion reaction in myelodysplastic syndrome- A case based approach |
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| Authors: | Merline Augustine Mohandoss Murugesan Chandran K. Nair Vineetha Raghavan Sangeetha K. Nayanar |
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| Affiliation: | 1. Dept. of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India;2. Dept. of Clinical Hematology and Medical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India;3. Dept. of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India;1. Azarbaijan-Gharbi Regional Blood Transfusion Center, Urmia, Iran;2. Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran;1. University of Milano-Bicocca, Monza, Italy;2. Hematology Division, ASST Monza, Italy;1. University of Milano-Bicocca, Monza, Italy;2. Hematology Division, ASST Monza, Italy;1. Department of transfusion medicine, Evercare Hospital, Dhaka, Bangladesh;2. Department of transfusion medicine, ICMR- National institute of immunohematology, Mumbai, India;3. Hematology and Stem cell Transplant, Evercare Hospital, Dhaka, Bangladesh |
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| Abstract: | ![]()
We present here a case report of a 27 year old female, with myelodysplatic syndrome suspected to have recurrent hyperhemolytic transfusion reactions (HHTR). Patient was transfusion dependent for ten years and was transfused with leukodepleted and irradiated Packed Red Blood Cells (PRBC). She presented with signs and symptoms of acute intravascular hemolysis, deranged coagulation profile with post transfusion Hb lower than baseline. Post transfusion workup was uneventful. She was managed conservatively with fluid support and methylprednisolone initially. After few uneventful transfusions, patient developed second episode of HHTR with compatible unit.Immunophenotype favored an inflammatory response possibly induced by monocytic lineage. As transfusion dependent, the patient required methylprednisolone as premedication and all subsequent transfusions were uneventful. |
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| Keywords: | Hyperhemolysis Myelodysplastic syndrome Macrophage activation PRBC transfusion |
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