Ann Lab Med.  2012 Jul;32(4):304-306. 10.3343/alm.2012.32.4.304.

Anaphylactic Transfusion Reaction in a Patient with Anhaptoglobinemia: The First Case in Korea

• Kim H
• Choi J
• Park KU
• Kim HS
• Min YH
• Kim MJ
• Kim HO

• KMID: 1380092
• DOI: http://doi.org/10.3343/alm.2012.32.4.304

Abstract

Anaphylactic transfusion reactions are rare complications of blood transfusions. Anhaptoglobinemia, a condition that has high incidence in Asia, can cause allergic transfusion reactions or anaphylaxis in severe cases. A 50-yr-old Korean woman was diagnosed with relapsed acute promyelocytic leukemia. She developed thrombocytopenia during chemotherapy and an anaphylactic transfusion reaction on the 4th and 5th platelet transfusions immediately after the transfusion of the platelet concentrates was initiated. Blood analysis showed no detectable serum haptoglobin. We examined her genetic phenotype and detected anhaptoglobinemia, which occurs because of an allelic deletion in the Hp gene cluster. The presence of an antibody against haptoglobin was detected by performing ELISA. To prevent anaphylactic reactions, apheresis platelets were transfused after washing. Consequently, anaphylactic transfusion reactions did not develop. Here, we report the first case of anhaptoglobinemia causing anaphylactic transfusion reaction in Korea.

Keyword

Platelet transfusion; Anaphylaxis; Haptoglobin

MeSH Terms

Alleles
Anaphylaxis/*etiology
Antineoplastic Agents/therapeutic use
Female
Gene Deletion
Haptoglobins/*genetics/immunology
Humans
Isoantibodies/immunology
Leukemia, Promyelocytic, Acute/complications/*diagnosis/drug therapy
Middle Aged
Phenotype
Platelet Transfusion/*adverse effects
Recurrence
Republic of Korea
Thrombocytopenia/complications/diagnosis

Figure

• 

  Fig. 1 Determination of Hp1 and Hp2 alleles and haptoglobin gene deletion from the patient and control individuals in PCR. Only a 315 bp band was amplified from the patient with homozygous for the Hp0 allele. Lane 1, patient; lane 2, Hp2/Hp1 heterozygote; lane 3, Hp2/Hp1 heterozygote; lane 4, Hp2/Hp0 heterozygote; lane 5, Hp2/Hp0 heterozygote; lane 6, Hp2/Hp1 heterozygote.

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