Severe anaphylactic reactions following transfusions of platelets to a patient with anti-Ch.
The high-frequency Chido (Ch) antigen, found predominantly in plasma, is a determinant of the C4d fragment of the C4 molecule and is acquired by red cells during in vivo complement activation. Antibodies are made by Ch- people who lack C4S. It has often been reported that anti-Ch (and anti-Rg) do not cause hemolytic transfusion reactions. Reported here is a case of a transfusion reaction caused by anti-Ch. The antibody did not cause red cell destruction, but did cause a life-threatening anaphylactic reaction during transfusion of plasma proteins in pooled platelets. The antibody was of the IgG4 subclass and might have caused a short-term, sensitizing anaphylactic response. This case, and one previously reported in which a patient with anti-Rg experienced a severe reaction to fresh-frozen plasma and a plasma derivative, illustrates that these antibodies can cause severe, life-threatening reactions in patients who receive plasma-containing components.
Westhoff
C M
CM
Clinical Laboratories of Lincoln, A Nichols Institute Laboratory, Nebraska.
Sipherd
B D
BD
Wylie
D E
DE
Toalson
L D
LD
D000707:Anaphylaxis / Q000209:etiology*; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001789:Blood Group Antigens / Q000276:immunology*; D003298:Coombs Test; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000009:adverse effects; D008875:Middle Aged
D001789:Blood Group Antigens; D007518:Isoantibodies