Three episodes of delayed hemolytic transfusion reactions due to multiple red cell antibodies, anti-Di(a), anti-Jk(b) and anti-E

Citation
H. Yasuda et al., Three episodes of delayed hemolytic transfusion reactions due to multiple red cell antibodies, anti-Di(a), anti-Jk(b) and anti-E, TRANSFUS SC, 23(2), 2000, pp. 107-112
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
TRANSFUSION SCIENCE
ISSN journal
0955-3886 → ACNP
Volume
23
Issue
2
Year of publication
2000
Pages
107 - 112
Database
ISI
SICI code
0955-3886(200010)23:2<107:TEODHT>2.0.ZU;2-7
Abstract
There is no report in which three episodes of delayed hemolytic transfusion reaction (DHTR) occurred from multiple antibodies to red cells (RBCs) in t he course of treatment of a patient. This paper describes episodes of anemi a and hyperbilirubinemia in concert with the development of three alloantib odies in a multiple transfused patient. The patient was a 71-year-old male suffering from valvular heart disease and hemophilia B with a history of tr ansfusions. Although he received compatible RBCs from 14 donors as judged b y a crossmatch test using the albumin-antiglobulin method, three episodes o f DHTR occurred after surgery. The first hemolytic episode on day 7 after s urgery was due to anti-Dia because of clinical and laboratory evidence whic h included jaundice, sudden increases in total bilirubin (T-Bil) and lactat e dehydrogenase (LD) levels, and a decrease (2.2 g/dl) in hemoglobin (Hb) l evel. The second hemolytic episode on day 16 resulted from newly producted anti-Jk(b). The patient experienced fever, fatigue, nausea and anorexia, an d laboratory data showed a second increase in T-Bil, a second decrease (3 g /dl) in Hb, and moderate elevations of blood urea nitrogen (BUN) and creati nine (CRE) levels. The third hemolytic episode on day 39 was due to anti-E. The patient complained of fever and fatigue and had a third unexplained dr op (1.5 g/dl) in Hb despite no bleeding. This is the first reported case in which three episodes of DHTR occurred from different red cell antibodies. (C) 2000 Elsevier Science Ltd. All rights reserved.