Hereditary spherocytosis in a patient undergoing coronary artery bypass grafting with cardiopulmonary bypass--a case report.
Hereditary spherocytosis is a genetically determined abnormality of red blood cells. It is the most common cause of inherited haemolysis in Europe and North America within the Caucasian population. We document a patient who underwent an aortocoronary bypass procedure on cardiopulmonary bypass. In view of the uncertain tolerance of the abnormal red cells in hereditary spherocytosis to cardiopulmonary bypass, we reviewed the patient's chart and analyzed recorded values of these parameters: free plasma haemoglobin, renal parameters, cystatin C, bilirubin, liver tests, urine samples. From the results, we can see that slight haemolysis-elevated bilirubin in the blood sample and elevated bilirubin and urobilinogen in the urine sample occurred on the first postoperative day. The levels of these parameters slowly decreased during the next postoperative days. There was no real clinical effect of this haemolysis on renal functions.
Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic Department of Anaesthesia and Intensive Care, Papworth Hospital, Papworth Everard, Cambridge, UK janspegar@hotmail.com.
J
J
Spegar
Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
H
H
Riha
Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
T
T
Kotulak
Department of Cardiac Surgery, Third Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Czech Republic.
T
T
Vanek
D000368:Aged; D017487:Ankyrins / Q000172:deficiency*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006461:Hemolysis; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D013103:Spherocytosis, Hereditary / Q000209:etiology* / Q000628:therapy
D017487:Ankyrins
cardiac surgery; cardiopulmonary bypass; haemolysis; hereditary spherocytosis