A Case of Delayed Hemolytic Transfusion Reaction in a Patient with Anti-c, Anti-E, and Anti-Jk(b).
- Author:
Serim KIM
1
;
Mina HUR
;
Kyu Man LEE
;
Wook CHUN
Author Information
1. Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea. dearmina@hanmail.net
- Publication Type:Case Report
- Keywords:
Delayed hemolytic transfusion reaction;
Multiple alloantibodies;
Anti-c;
Anti-E;
Anti-Jk(b)
- MeSH:
Bilirubin;
Blood Group Incompatibility;
Burns;
Coombs Test;
Emergencies;
Erythrocytes;
Follow-Up Studies;
Haptoglobins;
Hemoglobins;
Hemoglobinuria;
Humans;
Isoantibodies;
Korea;
L-Lactate Dehydrogenase;
Middle Aged;
Plasma;
Transplantation, Homologous;
Urinalysis
- From:Korean Journal of Blood Transfusion
2009;20(2):144-150
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Delayed hemolytic transfusion reaction (DHTR) due to multiple red blood cell (RBC) alloantibodies has rarely been reported in Korea. We report a case of DHTR in a patient with anti-c, anti-E, and anti-Jk(b). A 45-year-old man visited the emergency room with flame burn injury over 61% of his entire body. He received six units of packed RBCs and three units of fresh frozen plasma during the operation for excision and glycerol-preserved allografting. His hemoglobin (Hb) level gradually decreased from 13.5 g/dL on the operation day to 7.8 g/dL on the 11th postoperative day in spite of receiving three and two additional units of packed RBCs on the 8th and 9th postoperative days, respectively. His laboratory data was total bilirubin/direct bilirubin 15.9/11.4 mg/dL, lactate dehydrogenase 983 IU/L, haptoglobin 5.93 mg/dL and plasma hemoglobin 8.0 mg/dL. The urinalysis revealed hemoglobinuria, and the peripheral blood film showed moderate spherocytosis. Both the direct and indirect antiglobulin tests were positive, and the follow-up antibody identification test showed anti-c, anti-E, and Jk(b). His Hb levels increased after he was transfused with two units of packed RBCs without c, E, and Jk(b) antigens. This is a case of DHTR due to alloimmunization, which developed within a short interval after the patient had received multiple transfusions.
