Acute intravascular hemolysis secondaryto out-of-group platelet transfusion.
BACKGROUND
Acute intravascular hemolysis is rarely associated with platelet transfusion. Out-of-group single-donor platelets may cause hemolysis if the donor has high-titer ABO hemagglutinins.


METHODS
A 44-year-old woman, blood group A, was recently diagnosed with acute myeloid leukemia and was receiving chemotherapy. After the transfusion of apheresis platelets from a group O donor, back pain, hemoglobinuria, and hemoglobinemia developed, and her Hb dropped by 2.3 g per dL, despite the transfusion of 2 units of RBCs.


RESULTS
Investigation revealed acute intravascular hemolysis with a positive DAT due to anti-A(1) on her RBCs. The donor's titer of anti-A(1) was greater than 16,000.


CONCLUSIONS
Review of published cases raises the possibility that hemolytic reactions to out-of-group platelets may be more frequent since the use of apheresis platelets has increased.
Larsson
L G
LG
Department of Pathology, Scott & White Clinic and Memorial Hospital and Scott, Sherwood and Brindley Foundation, Texas A&M University Health Science Center, College of Medicine, Temple, Texas 76508, USA.
Welsh
V J
VJ
Ladd
D J
DJ
D000328:Adult; D000372:Agglutination Tests / Q000379:methods; D001663:Bilirubin / Q000097:blood; D001787:Blood Group Incompatibility / Q000150:complications*; D004903:Erythrocyte Aggregation / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D017713:Platelet Transfusion / Q000009:adverse effects*
D006454:Hemoglobins; D007770:L-Lactate Dehydrogenase; D001663:Bilirubin