The first reported case of anti-Dob causing an acute hemolytic transfusion reaction.
The antibodies of the Dombrock blood group system have only rarely been encountered in transfusion practice, and anti-Dob has not previously been implicated in an acute hemolytic transfusion reaction. We have encountered the first such case involving a chronically transfused black female with hemoglobin SS disease and multiple antibodies in her serum. During a previous admission for sickle cell crisis, the patient received 3 units of compatible blood with no untoward effects. Serum obtained 21 days later contained, in addition to the known antibodies, anti-S plus an unidentified antibody showing characteristics of HTLA. Blood lacking the E, K1, Fy(a), Jk(b) and S antigens was obtained, and 2 least incompatible units were transfused. While administering the second unit, the patient complained of fever and low back pain, and hemoglobinemia was detected. Anti-Dob was identified in the post-reaction samples by absorption-elution tests, and the patient was confirmed to be Do(a+b-). The first unit transfused during this hemolytic episode tested Do (b+). This case, and a similar case involving anti-Doa reported in 1986, strengthens the belief that Dombrock antibodies are clinically significant and illustrates the need for their differentiation, prior to transfusion from less clinically significant HTLA antibodies.
Blood Bank and Transfusion Service, New York Hospital-Cornell Medical Center, New York, NY 10021.
G
G
Halverson
E
E
Shanahan
I
I
Santiago
R
R
Mabile
T
T
Thurrell
A M
AM
Strupp
C F
CF
Wolf
P
P
Spruell
M K
MK
Moulds
D000208:Acute Disease; D000328:Adult; D000755:Anemia, Sickle Cell / Q000628:therapy; D005260:Female; D006461:Hemolysis / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D065227:Transfusion Reaction
D007518:Isoantibodies