title: Fatal delayed hemolytic transfusion reaction associated with anti-Di(b) and anti-E.
abstract: We report the death of a 61-year-old Japanese man massively transfused during and after emergency aortic surgery. Postoperative on day 8, he died after cardiac arrest associated with hyperkalemia. Indirect antiglobulin testing demonstrated both anti-Di(b) and anti-E antibodies pre-transfusion, and elevation of their titers as the delayed hemolytic transfusion reaction evolved. Monocyte monolayer assay (induction of reactive monocytes) and flow cytometry (increase of IgG1 and/or IgG3) gave evidence of the clinical significance of both antibodies. Anti-Di(b) must be considered when an antibody to a high incidence antigen is found in Japanese and other Mongoloid populations.
authors.affiliation: Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan. yuha@gifu-u.ac.jp
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hatano
authors.forename: Setsuko
authors.initials: S
authors.lastname: Otsuka
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Chousa
authors.forename: Shunnichi
authors.initials: S
authors.lastname: Saito
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Nollet
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ohto
authors.forename: Katsuya
authors.initials: K
authors.lastname: Shimabukuro
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Takemura
authors.forename: Akira
authors.initials: A
authors.lastname: Hara
mesh_terms: D000784:Aortic Dissection / Q000601:surgery; D000906:Antibodies / Q000276:immunology; D001787:Blood Group Incompatibility / Q000097:blood* / Q000276:immunology; D006348:Cardiac Surgical Procedures / Q000379:methods; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
chemical_list: D000906:Antibodies; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System