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.
Halverson
G
G
Blood Bank and Transfusion Service, New York Hospital-Cornell Medical Center, New York, NY 10021.
Shanahan
E
E
Santiago
I
I
Mabile
R
R
Thurrell
T
T
Strupp
A M
AM
Wolf
C F
CF
Spruell
P
P
Moulds
M K
MK
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