[Hemolysis can conceal another hemolysis].
We report a delayed haemolytic reaction during the course of a severe HELLP syndrome, which required red blood cell transfusions. Haemolysis was mainly ascribed to the erythrocyte alloantibody anti-Fy a. The fact that this antibody was undetectable before transfusions (despite cross-matching and anti-erythrocyte antibody screening test) emphasizes the limits of these tests for low antibody concentrations. Moreover, this patient, who had a remarkable obstetrical history, received red blood cell transfusions matched for Rhesus and Kell antigens. The opportunity to perform a more extended phenotype screening for patients at high-risk to develop multiple alloantibodies is discussed.
Desnos-Malchiodi
P
P
Service de réanimation chirurgicale et d'anesthésiologie, CHU, I, Rouen, France.
Zenner-Zerrouqa
C
C
Bastit
D
D
Dureuil
B
B
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis*; D003951:Diagnostic Errors; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D017359:HELLP Syndrome / Q000150:complications* / Q000628:therapy; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000032:analysis; D011247:Pregnancy
D006454:Hemoglobins; D007518:Isoantibodies