title: Hyperhemolytic Syndrome Complicating a Delayed Hemolytic Transfusion Reaction due to anti-P1 Alloimmunization, in a Pregnant Woman with HbO-Arab/β-Thalassemia.
abstract: BACKGROUND
  Hyperhemolytic Syndrome or Hyperhemolytic Transfusion Reaction (HHTR), a life-threatening subset of Delayed Hemolytic Transfusion Reaction (DHTR) is characterized by destruction of both transfused and autologous erythrocytes evidenced by a fall in post transfusion hemoglobin below the pre-transfusion level.
  
  
  METHODS
  We describe a case of DHTR due to anti-P1 alloimmunization manifesting with hyperhemolysis in a 30-year-old Greek Pomak woman with thalassemia intermedia (HbO-Arab/β-thalassemia), during the11thweek of her first gestation. She was successfully managed with avoidance of further transfusions and administration of IVIG and corticosteroids.
  
  
  CONCLUSIONS
  A high index of suspicion for HHTR is of vital importance among clinicians especially since optimal methods for its prevention and treatment remain yet to be defined. Early recognition of HHTR leading to prompt cessation of additional transfusions and initiation of immunosuppressive treatment can be life-saving, especially in clinical settings where limited therapeutic options are available, such as in pregnancy.
authors.affiliation: Blood Transfusion Centre, University General Hospital of Evros, Alexandroupolis, Greece; Department of Hematology, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Bezirgiannidou
authors.affiliation: Department of Hematology, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Christoforidou
authors.affiliation: Blood Transfusion Centre, University General Hospital of Evros, Alexandroupolis, Greece.
authors.forename: Eftychia
authors.initials: E
authors.lastname: Kontekaki
authors.affiliation: Blood Transfusion Centre, University General Hospital of Evros, Alexandroupolis, Greece.
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Anastasiadis
authors.affiliation: Department of Hematology, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
authors.forename: Spyros I
authors.initials: SI
authors.lastname: Papamichos
authors.affiliation: Department of Hematology, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
authors.forename: Helen
authors.initials: H
authors.lastname: Menexidou
authors.affiliation: Department of Hematology, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Margaritis
authors.affiliation: Blood Transfusion Centre, University General Hospital of Evros, Alexandroupolis, Greece.
authors.forename: Georges
authors.initials: G
authors.lastname: Martinis
authors.affiliation: Department of Pediatrics, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
authors.forename: Elpis
authors.initials: E
authors.lastname: Mantadakis