Korean J Blood Transfus.  2009 Aug;20(2):144-150.

A Case of Delayed Hemolytic Transfusion Reaction in a Patient with Anti-c, Anti-E, and Anti-Jk(b)

Affiliations
  • 1Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea. dearmina@hanmail.net
  • 2Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, Korea.
  • 3Department of Burn Surgery, Hallym University College of Medicine, Seoul, Korea.

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.

Keyword

Delayed hemolytic transfusion reaction; Multiple alloantibodies; Anti-c; Anti-E; Anti-Jk(b)

MeSH Terms

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
Bilirubin
Haptoglobins
Hemoglobins
Isoantibodies
L-Lactate Dehydrogenase
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