Delayed hemolytic transfusion reaction caused by a primary immune response

Delayed hemolytic transfusion reactions usually occur as a result of a secondary immune response with maximal hemolysis occurring seven days posttransfusion. We report a delayed hemolytic transfusion reaction in which hemoglobinuria, anemia, and reticulocytosis developed four weeks after transfusion. The incriminated antibody, anti-C, was first detected eight weeks posttransfusion using enzyme-treated red blood cells. We conclude, that in all likelihood, this hemolytic transfusion reaction was due to a primary immune response, this case illustrates the importance of sequential testing in cases of suspected transfusion reactions.     

Delayed hemolytic transfusion reaction caused by anti-P1 antibody

A 67-year-old white woman received transfusions of a total of 87 units of whole blood and red blood cells during and within 48 hours following a pneumonectomy. Although she had previously received blood transfusions, unexpected antibodies were not detectable by routine screening. On the second postoperative day, she developed fever, hemoglobinemia, hemoglobinuria, and oliguria. However, the direct antiglobulin test and the antibody screen were negative. On the eighth postoperative day, an IgM anti-P1 antibody was detected for the first time. This anti-P1 antibody increased in thermal amplitude from 22 to 37 C, but remained IgM. The circulating transfused P1-positive cells decreased progressively without evidence of bleeding. Testing of the patient's preoperative blood at 15 C found her serum to be weakly reactive with P1 cells, while her own cells were P2. Thus, an anamnestic response to the P1 antigen is the most likely cause of her delayed hemolytic transfusion reaction.     

Delayed hemolytic transfusion reaction caused by the second example of anti-K19

A second example of anti-K19 has been identified in the serum of a black patient immunized by blood transfusions. The antibody was responsible for delayed hemolysis of transfused incompatible red blood cells. The patient's red blood cells are K:--19 but are otherwise of common Kell phenotype. The K19 antigen is closely associated with the Kell blood group although there is, as yet, no pedigree information to confirm that it is produced by the Kell gene. Tests on 10,757 group O blood donors have not revealed any further examples of the K:--19 phenotype.     

A case report of a hemolytic transfusion reaction caused by anti-Holley

Clinical and laboratory investigation of a black male patient, who received emergency transfusion of blood incompatible for a high incidence antigen, provided evidence for the pathogenetic importance of high titer anti-Holley antibodies with poor avidity. The red blood cells of the patient and two siblings were remarkable in being negative for two high incidence antigens, Hy and hrS, and weak for a third, Gy.     

Delayed overt hemolytic transfusion reaction due to anti-U antibody

A patient is described who developed a delayed hemolytic transfusion reaction, 11 days posttransfusion, caused by anti-U. This case illustrates the difficulty that can occur in distinguishing a delayed transfusion reaction from autoimmune hemolytic disease when the antibody involved is directed against a high incidence blood group antigen.     

Acute hemolytic transfusion reaction in a pediatric patient following transfusion of apheresis platelets

The practice of transfusing ABO-incompatible platelets, driven primarily by concerns about inventory management, has been considered generally safe because the accompanying plasma is usually diluted in the recipient's total blood volume. However, if the platelet product contains a large volume of plasma or a high concentration of incompatible isoagglutinin, there may be hemolysis of the recipient's red cells. Patients with a small blood volume, such as babies and children, are considered to be at particular risk for such a complication. We describe the case of a baby who suffered massive hemolysis of her group A red cells after transfusion of group O Apheresis Platelets containing a high-titered anti-A isoagglutinin. We also offer a review of the literature on this subject and recommendations to avoid acute hemolytic reactions as a result of platelet transfusion.     

抗-Jk~b导致溶血性输血反应1例

Kidd血型不合引起的溶血性输血反应,在临床中比较罕见,因而常被忽视,现将1例因抗-Jkb所致输血反应的调查报告如下.     

低频率抗Mur抗体引起溶血性输血反应的调查研究

目的研究抗Mur抗体血型血清学特征，调查其在输血医学中临床意义。方法对2例患者的血清，与已知血型的试剂红细胞和4个已知Mur抗原，在盐水介质、低离子间接抗球蛋白介质，分析鉴定出其抗体的特异性。结果这2例患者与已知血型的试剂红细胞在多种反应介质中的反应结果显示患者血清中含有抗Mur抗体，患者血清与4个已知Mur抗原的反应证实该例抗体只与Mur抗原反应。结论该例同种抗体为特异性抗Mur抗体，在临床会引起溶血性输血反应。在东方人群中Mihenberger血型抗体常规筛选鉴定值得探讨。     

低频率抗Mur抗体引起溶血性输血反应的调查研究

目的研究抗Mur抗体血型血清学特征,调查其在输血医学中临床意义.方法对2例患者的血清,与已知血型的试剂红细胞和4个已知Mur抗原,在盐水介质、低离子间接抗球蛋白介质,分析鉴定出其抗体的特异性.结果这2例患者与已知血型的试剂红细胞在多种反应介质中的反应结果显示患者血清中含有抗Mur抗体,患者血清与4个已知Mur抗原的反应证实该例抗体只与Mur抗原反应.结论该例同种抗体为特异性抗Mur抗体,在临床会引起溶血性输血反应.在东方人群中Miltenberger血型抗体常规筛选鉴定值得探讨.     

糖尿病患者抗Pra抗体致迟发性溶血性输血反应及分析

蛋白酶敏感的Pr抗原~([1-2])最早被Marsh和Jenkins~([3])命名为sp_1,被Roelcke~([4])命名为HD.它们通常被冷抗体性质的IgM型人源单克隆自身抗体检测到,这些自身抗体或来自冷凝集素疾病或是由感染引发的~([5]),只有在罕见的情况下是与自身免疫性溶血性贫血相关~([6-7].     

Fatal delayed hemolytic transfusion reaction due to anti-c + E

A 72-year-old man with a peptic ulcer received seven units of apparently compatible red blood cells. Six days after the last unit, he had a hemolytic transfusion reaction manifested by high fever, marked fall in hematocrit, hemoglobinemia, hemoglobinuria, severe bilirubinemia and oliguria. He went on to become uremic, hyperkalemic, anuric and died five days later. Serologic studies showed that the donor and recipient bloods were completely compatible prior to the transfusions and that unexpected antibodies were not detected. The anamnestic response from donor antigens was precipitous even after a latent period of six days.     

Delayed hemolytic transfusion reactions in sickle cell anemia

Delayed hemolytic transfusion reaction (DHTR) developed in three patients with sickle cell anemia seen over an 18-month period at Cook Country Hospital. The DHTR was associated with severe pain crisis, with spherocytic hemolytic anemia, a positive direct antiglobulin test result, previously undetected erythrocyte alloantibodies, and disappearance of Hb A on cellulose acetate electrophoresis. Delayed hemolytic transfusion reactions may be more common than is generally recognized and should be considered when a patient has a sickle cell pain crisis shortly after receiving a transfusion.     

An acute hemolytic transfusion reaction due to anti-IH in a patient with sickle cell disease

BACKGROUND: A hemolytic transfusion reaction (HTR) due to anti-IH is reported in a patient with sickle cell disease (SCD). CASE REPORT: An 18-year-old woman with SCD and a complete phenotype on file had been identified as group B-positive with negative antibody-screening tests and had received 1 unit of packed RBCs. Ten days later, she was readmitted in painful crisis with a Hb of 4.2 g per dL. Antibody-screening tests and panel cells were positive at all test phases with a negative autocontrol, which suggested alloantibodies. Phenotypically matched group O RBCs were issued emergently. After the transfusion of 100 mL, the patient had an HTR with chills, fever, and tachycardia and laboratory findings of hemoglobinemia, hemoglobinuria, and negative DATs. A high-titer, IgM anti-IH with a high thermal amplitude (reactive with group O, but not group B RBCs at 37 degrees C) was identified. Autologous RBCs appeared to have normal I antigen expression, but less H antigen than pooled group B RBCs. She was given group B RBCs, uneventfully, by use of a blood warmer. CONCLUSIONS: This is a rare case of anti-IH as the cause of a HTR, as a serologic problem that may be seen in SCD, and as an autoantibody that may mimic an alloantibody. Ironically, this HTR resulted from the effort to provide phenotypically matched RBCs, which necessitated the selection of group O RBCs.