Acute hemolytic transfusion reactions due to multiple alloantibodies including anti-E, anti-c and anti-Jkb.
We report a case of two consecutive episodes of acute hemolytic transfusion reactions (HTRs) due to multiple alloantibodies in a 34-yr-old man who suffered from avascular necrosis of left femoral head. He received five units of packed red blood cells (RBCs) during surgery. Then the transfusion of packed RBCs was required nine days after the surgery because of the unexplained drop in hemoglobin level. The transfusion of the first two units resulted in fever and brown-colored urine, but he received the transfusion of another packed RBCs the next day. He experienced even more severe symptoms during the transfusion of the first unit. We performed antibody screening test, and it showed positive results. Multiple alloantibodies including anti-E, anti-c and anti-Jkb were detected by antibody identification study. Acute HTRs due to multiple alloantibodies were diagnosed, and the supportive cares were done for 6 days. We suggest the antibody screening test should be included in the panel of pretransfusion tests for safer transfusion, and it is particularly mandatory for the patients with multiple transfusions, pregnant women, and preoperative patients.
Park
Tae Sung
TS
Department of Laboratory Medicine, Pusan National University College of Medicine, Busan, Korea. hhkim@pusan.ac.kr
Kim
Ki Uk
KU
Jeong
Woo Jin
WJ
Kim
Hyung Hoi
HH
Chang
Chulhun L
CL
Chung
Joo Seop
JS
Cho
Goon Jae
GJ
Lee
Eun Yup
EY
Son
Han Chul
HC
D000328:Adult; D001789:Blood Group Antigens / Q000276:immunology; D001787:Blood Group Incompatibility; D001788:Blood Grouping and Crossmatching / Q000379:methods; D005260:Female; D006461:Hemolysis / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D008297:Male; D011247:Pregnancy; D065227:Transfusion Reaction
D001789:Blood Group Antigens; D007518:Isoantibodies