A Case of Autoimmune Hemolytic Anemia in a Renal Transplant Recipient due to Anti-A of Donor Origin.
- Author:
Young Tai SHIN
;
Jon Kee LEE
;
Hyuk Ki MIN
;
Kye Cheol KWON
;
Sun Hoe KOO
;
Jong Woo PARK
;
Gang Wook LEE
- Publication Type:Case Report
- MeSH:
Anemia, Hemolytic;
Anemia, Hemolytic, Autoimmune*;
Antibody Formation;
Bilirubin;
Blood Banks;
Blood Group Antigens;
Humans;
Immunosuppressive Agents;
Kidney;
Kidney Transplantation;
Male;
Middle Aged;
Plasma;
Prednisolone;
Reticulocyte Count;
Siblings;
Tissue Donors*;
Transplantation*
- From:Korean Journal of Blood Transfusion
1994;5(1):57-62
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Autoimmune hemolytic anemia due to antibody formation against the A or B antigen in renal transplant recipients has been reported on rare occasions. We experienced a case of autoimmune hemolytic anemia which developed 11 days after renal transplantation during CsA and prednisolone administration as immunosuppressive agents. The patient was a 46 year old male, blood group was Rh(+) A, who had received a kidney from his Rh(+) O, HLA haploty'pe identical elder brother. He was transfused with three units of Rh(+) A RBCs preoperatively and his hemoglobin level was 9.2g/dl 1 day after transplantation. After 11 to 12 days posttransplantation, the hemoglobin level dropped to 3.8g/dl. A peripheral blood smear showed marked spherocytosis and polychromatophilia. The reticulocyte count was increased to 4.2%, and total bilirubin was increased to 2.91mg/dl. The LDH was raised to 561 IU/L and the plasma Hb level was 6.Smg/dl. Blood bank tests confirmed that the autoantibody cause hemolytic anemia was anti-A. If transplant recipients of blood groups A, B, or AB, who recieve organs from blood group 0 donors, have hemolytic anemia and ABO discrepancy, the possibility of AIHA due to anti-A or anti-B should be considered.