[Transient episode of erythrocytic autoimmunization in a patient alloimmunized at the end of multiple transfusions].
Delayed hemolytic reaction is a well recognized hazard of blood transfusion and occurs mainly in recipients with alloantibodies, due to sensitization to red cell antigens by previous transfusion or pregnancy. Less frequently, such a reaction may be associated with the presence of red cell autoantibodies appearing after alloimmunization. We report the observation of a patient with chronic myelomonocytic leukemia, who presented a transitory episode of delayed hemolysis after multiple transfusions. At first, anti-Kell alloantibodies were identified and, two weeks later, warm "broad-specific" autoantibodies were detected by direct and indirect antiglobulin tests. The anemia was associated with unstable angina. The patient received multiple transfusions and prednisone. After 3 weeks, the transfusion needs diminished and the autoantibodies progressively disappeared from the serum. The direct antiglobulin test was negative 4 months later. This observation illustrates the poorly understood relationships between erythrocytic alloantigen exposure and red cell autoimmunization.
Tissot
J D
JD
Centre de transfusion sanguine de la Croix-Rouge suisse, Lausanne.
Taliano
V
V
Schneider
P
P
D000368:Aged; D001323:Autoantibodies / Q000302:isolation & purification; D015551:Autoimmunity; D003298:Coombs Test; D004912:Erythrocytes / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000302:isolation & purification*; D007626:Kell Blood-Group System / Q000276:immunology; D015477:Leukemia, Myelomonocytic, Chronic / Q000628:therapy*; D008297:Male; D065227:Transfusion Reaction
D001323:Autoantibodies; D007518:Isoantibodies; D007626:Kell Blood-Group System
Episode transitoire d'autoimmunisation érythrocytaire chez un patient alloimmunisé à la suite de transfusions multiples.