Case report | 09-October-2019
In situations when a patient's antibody detection test is negative, many institutions have moved from an indirect antiglobulin test (IAT) crossmatch to an electronic crossmatch system. Here we report a case of an acute hemolytic transfusion reaction attributable to anti-Dia in a patient with a negative antibody detection test. A 22-year-old female patient with a diagnosis of β thalassemia and sickle cell anemia commenced a routine exchange transfusion of 5 units of red blood cells
Arthur J. Joyce,
Kelli M Quantock,
Ray Banh,
Yew-Wah Liew
Immunohematology, Volume 33 , ISSUE 1, 6–8
Case report | 09-October-2019
Anti-Ata is a rare alloantibody that can be clinically significant. We report a case of a woman who, after emergency-released uncrossmatched red blood cell transfusion, experienced an acute hemolytic transfusion reaction attributed to anti-Ata. The case presented herein highlights the importance of recognizing that anti-Ata may indeed cause acute hemolytic reactions.
Jay S. Raval,
Sarah K. Harm,
Bethann Wagner,
Darrell J. Triulzi,
Mark H. Yazer
Immunohematology, Volume 32 , ISSUE 4, 140–142
Article | 21-April-2020
A hemolytic transfusion reaction due to anti-Fy3 is reported in an African American patient with no history of sickle cell disease. This 82-year-old African American woman received two units of RBCs for anemia (Hb 7g/dL) on admission for a left hip fracture. On hospital Day 7, the patient underwent left hip endoprosthesis surgery; she received two units of RBCs on the second postoperative day due to Hb of 6.1g/dL. Her urine was dark during surgery and postoperatively. Her posttransfusion plasma
Horatiu Olteanu,
David Gerber,
Kara Partridge,
Ravindra Sarode
Immunohematology, Volume 21 , ISSUE 2, 48–52
Case report | 11-March-2020
In general, naturally occurring cold autoagglutinins react optimally at low temperatures. We describe a young child who experienced an acute hemolytic transfusion reaction by an unusual autoanti-I. The IgM autoanti-I was detected at 4°C (titer 256) and also reacted at 30°C. This case highlights the potential hazard of transfusing units of blood immediately upon removal from the blood refrigerator, especially into neonates and children of small stature.
Nay Win,
Sally Rahman,
Philip Gold,
Susan Ward
Immunohematology, Volume 27 , ISSUE 3, 101–103
Case report | 24-March-2020
Wra is a low-prevalence antigen. Anti-Wra is a relatively common antibody present in approximately 1 in 100 healthy blood donors. Anti-Wra is reported to cause different degrees of hemolysis in transfusion and in HDN, ranging from benign to severe. This report describes an acute overt hemolytic transfusion reaction in a patient whose serum contained anti-Wra and who received a Wr(a+) RBC component.
Fouad N. Boctor
Immunohematology, Volume 24 , ISSUE 3, 113–115
Article | 14-October-2020
A fatal transfusion reaction due to anti-Ku in a Knull (Ko) patient is reported. The patient was transfused with 34 units of incompatible RBCs during 44 days of hospitalization. Apart from the first transfusion, all subsequent transfusions failed to raise the patient’s Hb. No serum antibody was identified until he was transferred to another hospital for dialysis. A compatibility test demonstrated a weak antibody and autocontrol reacting at room temperature by a manual polybrene method
Marie Lin,
Chang Lin Wang,
Fu-Sen Chen,
Li-Hwa Ho
Immunohematology, Volume 19 , ISSUE 1, 19–21
Article | 16-February-2021
allow ABO-incompatible platelets to be issued to adult patients, and up to 40 percent of platelets issued are incompatible.3,4 The major risk associated with this practice is an acute hemolytic transfusion reaction (AHTR), typically due to minor ABO incompatibility in which donor antibodies hemolyze recipient red blood cells (RBCs). The most common scenario involves a group A recipient receiving a platelet unit obtained via apheresis from a group O donor who has a high anti-A titer.2 As seen in the
J. Guarente,
M. Harach,
J. Gould,
J.K. Karp,
A.R. Peedin
Immunohematology, Volume 35 , ISSUE 3, 91–94
Article | 10-April-2021
patient with an acute hemolytic transfusion reaction (AHTR) after the transfusion of 1 crossmatch-incompatible Yt(a+) RBC unit.
Case Report
In 2016, an 83-year-old white female patient of Croatian ancestry was admitted to the hospital with hematemesis from a duodenal ulcer. The patient’s hospital admission was attributed to poorly controlled anticoagulant therapy for the management of deep venous thrombosis, which previously led to cerebral infarction. Admission hemoglobin (Hb) was 6.6 g/dL and
M. Raos,
N. Thornton,
M. Lukic,
B. Golubic Cepulic
Immunohematology, Volume 37 , ISSUE 1, 13–17
Article | 10-April-2021
beats per minute [bpm]; normal range 60–100 bpm). Her body temperature rose from 37 to 38.1°C, and her O2 saturation level dropped to 75 percent (normal >95%). The transfusion was immediately stopped, and the patient was transferred to the intensive care unit. The blood gas analysis showed reduced PO2 and increased lactate, and the blood samples taken right after the transfusion reaction showed visible hemolysis. Laboratory tests showed normal haptoglobin, increased total bilirubin (TB), high levels
A. Espinosa,
L.J. Garvik,
N. Trung Nguyen,
B. Jacobsen
Immunohematology, Volume 37 , ISSUE 1, 20–24
Case report | 09-October-2019
, was transfused. The following day, her Hb was unchanged, lactic acid dehydrogenase increased from 951 to 2464 U/L, potassium increased from 3.7 to 4.6 mEq/L, creatinine increased from 0.60 to 0.98 mg/dL, and the patient developed a 38.4°C fever. These findings are consistent with a delayed hemolytic transfusion reaction (DHTR), mediated by anti-Joa, occurring 2 weeks after the first RBC transfusion. Further care could not be provided because the patient left the hospital against medical advice
Ryan P. Jajosky,
Wendy C. Lumm,
Scott C. Wise,
Roni J. Bollag,
James F. Shikle
Immunohematology, Volume 33 , ISSUE 2, 73–75
Case report | 16-October-2019
RHCE*ceEK/ RHCE*ceAR alleles. The patient was previously alloimmunized to D, C, and E and possibly hrS. Further transfusion of D–C–E–K– RBCs resulted in a suspected acute hemolytic transfusion reaction and the subsequent identification of anti-c. Monocyte monolayer assay testing suggests clinical significance with a range of 29.5–38.5 percent reactive monocytes.
Tiffany K. Walters,
Thomas Lightfoot
Immunohematology, Volume 34 , ISSUE 3, 109–112
Case report
Ashwini Bennett,
Ray K. Boyapati,
Frank S. Hong
Immunohematology, Volume 31 , ISSUE 4, 163–165
Case report | 21-March-2020
A case of hyperhemolytic transfusion reaction attributable to antiFy3 in a 30-year-oldAfricanAmerican woman with a history of sickle cell disease is reported. The patient was admitted for vaso-occlusive sickle cell crisis and received 4 units of packed RBCs secondary to worsening symptomatic anemia (Hb 5.0 g/dL). On admission,the patient’s antibody screen and identification showed anti-V and antiE,and her antibody history included anti-E,-C,-Jkb,-N,-V,-S,-Sla,and a cold agglutinin with
Meredith A. Reyes,
Orieji C. Illoh
Immunohematology, Volume 24 , ISSUE 2, 45–51
Case report | 27-December-2020
. The patient's chart revealed that vancomycin, reported to be a cause of non-immune agglutination of red cells, had been injected into the IV tubing one hour prior to transfusion. Further testing confirmed that the patient's febrile response to transfusion was consistent with a nonhemolytic transfusion reaction and was unrelated to the drug-induced, pseudo ABO problem.
Denise M. Gilbert,
Ronald E. Domen
Immunohematology, Volume 5 , ISSUE 4, 119–120
Article | 09-November-2020
. It was thought that the original low titer of anti-A reflected compromised immune homeostasis in an elderly patient and that stimulation by incompatible blood in those circumstances resulted in a delayed hemolytic transfusion reaction that triggered, exacerbated, or was accompanied by an autoimmune response manifesting as PCH.
M.A. Wodzinski,
R.C. Collin,
D.J. Booker,
R. Stamps,
J.D. Bellamy,
R.J. Sokol
Immunohematology, Volume 13 , ISSUE 2, 54–57
Case report | 27-April-2020
,she did not develop laboratory or clinical evidence of acute hemolysis. The patient’s anti-Jra had a pretransfusion titer of 4 and a monocyte monolayer assay (MMA) reactivity of 68.5% (reactivity > 5% is considered capable of shortening the survival of incompatible RBCs). The titer increased fourfold to 64 and the MMA reactivity was 72.5% on Day 10 posttransfusion. Review of laboratory data showed evidence of a mild delayed hemolytic transfusion reaction by Day 10 posttransfusion. Despite
Shan Yuan,
Rosalind Armour,
Allison Reid,
Khaled F. Abdel-Rahman,
Michael Phillips,
Dawn M. Rumsey,
Theresa Nester
Immunohematology, Volume 21 , ISSUE 3, 97–101
Case report | 09-October-2019
Marcia Marchese
Immunohematology, Volume 33 , ISSUE 3, 114–118
Case report | 17-March-2020
Ranie Koshy,
Bhishma Patel,
Jonathan S. Harrison
Immunohematology, Volume 25 , ISSUE 2, 44–47
Letter to Editor | 09-November-2020
Cathy Litty
Immunohematology, Volume 13 , ISSUE 3, 102–103
Letter to Editor | 09-November-2020
Liz Harris
Immunohematology, Volume 13 , ISSUE 3, 102–103
Report | 01-December-2019
Maryse St-Louis,
André Lebrun,
Mindy Goldman,
Marianne Lavoie
Immunohematology, Volume 29 , ISSUE 4, 136–140
Article | 15-February-2021
lacking low-prevalence antigens. An important recent report of an acute hemolytic transfusion reaction due to anti-Sc2 provides an excellent example of the potential adverse consequences of categorizing low-prevalence antibodies as “clinically insignificant.”10 In their patient with a previously identified anti-Sc2, electronic or immediate-spin crossmatches were performed rather than compatibility testing using an indirect antiglobulin test because of an assumption that anti-Sc2 was not clinically
P.A.R. Brunker,
W.A. Flegel
Immunohematology, Volume 35 , ISSUE 2, 48–50
Case report | 20-December-2020
Previous reports on the clinical significance of anti-Csa(Cost-Stirling) have presented conflicting data. We report our findings, over an 8-month period, of a patient whose serum contained anti-Csa and anti-Fya. Nineteen donor units of ABO and Rh-matched, Fya-negative red cells, which were crossmatch incompatible, were transfused with no clinical, serological, or biochemical evidence of a hemolytic transfusion reaction.
Thom Sererat,
Jan Alexander,
Jack Beatty
Immunohematology, Volume 6 , ISSUE 3, 71–72
Article | 10-November-2020
Autoantibodies may cause severe hemolytic anemia, but only rarely are they the cause of a hemolytic transfusion reaction due to the destruction of transfused allogeneic blood. In two patients, autoantibody was detected shortly after blood transfusion. The first case was a D-negative patient who produced an autoanti-Ce and subsequently developed hemoglobinuria and hyperbilirubinemia. The second case was a patient who developed an autoanti-Wrb that caused severe hemolysis that resulted in death.
D. Chan,
G.D. Poole,
M. Binney,
M.D. Hamon,
J.A. Copplestone,
A.G. Prentice
Immunohematology, Volume 12 , ISSUE 2, 80–83
Article | 16-February-2021
–). For E+ patients with anti-e-like, R2R2 RBCs can be used; the alleles that result in e+var phenotypes are often associated with a D variant, however; therefore, stimulation of anti-D is a risk if a D variant has not been excluded (especially important in women of childbearing potential).
Anti-CW is a relatively common antibody but has not been reported to cause a transfusion reaction, and IAT-compatible blood may be selected (approximately 97% of donors are CW–). Anti-CW has been implicated in HDFN
N.M. Thornton,
S.P. Grimsley
Immunohematology, Volume 35 , ISSUE 3, 95–101
Case report | 06-December-2020
We present the differential diagnosis for a Coombs-positive immune hemolysis having onset during hospitalization and, in particular, during the postoperative period. The stimulus for this article was a delayed hemolytic transfusion reaction (DHTR) due to anti-U following open-heart surgery. The initial clinical and serologic findings led us to consider other causes of immune hemolysis which are reviewed in this article. To our knowledge, this is the fourth case of a DHTR due to anti-U to be
Gnanasagren Sathaseevan Pillay,
Betty Womack,
S. Gerald Sandler
Immunohematology, Volume 9 , ISSUE 2, 41–46
Review
Reticulocytes can be separated from more mature red blood cells based on differences in density. A method for obtaining autologous reticulocytes in ethylenediaminetetraacetic acid (EDTA) whole blood samples containing both autologous and transfused cells uses a microhematocrit centrifuge. The less dense reticulocytes harvested from the top 5 mm of microhematocrit tubes can be used to determine the patient’s phenotype or assess whether a transfusion reaction is taking place. This method
Christy W. Hall
Immunohematology, Volume 31 , ISSUE 4, 152–154
Article | 09-November-2020
Regina M. Leger,
Patricia A. Arndt,
Asuncion Co,
Lauren O’Brien,
George Garratty
Immunohematology, Volume 13 , ISSUE 3, 93–96
Review | 16-October-2019
This article reviews information regarding the clinical significance of antibodies to antigens in the blood group collections, the 700 series of low-incidence antigens, and the 901 series of high-incidence antigens. Antibodies to many of the antigens in these groups are rarely encountered, meaning that available information is limited. For a few, the clinical significance— the potential to cause reduced survival of transfused antigen-positive red blood cells, a hemolytic transfusion
Christine Lomas-Francis
Immunohematology, Volume 34 , ISSUE 2, 39–45
Letter | 14-October-2020
Mark T. Friedman,
Alan P. Carioti
Immunohematology, Volume 17 , ISSUE 3, 90–91
Article | 03-November-2020
disease. Anti-GIL may have been responsible for a hemolytic transfusion reaction and results of monocyte monolayer assays of two of the anti-GIL suggested a potential to cause destruction of transfused GIL+ RBCs.
Geoff Daniels,
E. Nicole DeLong,
Virginia Hare,
Susan T. Johnson,
Pierre-Yves LePennec,
Delores Mallory,
M. Jane Marshall,
Cindy Oliver,
Peggy Spruell
Immunohematology, Volume 14 , ISSUE 2, 49–52
Case report | 01-December-2019
A 49-year-old white man with blood group AB, D+ was found to have alloanti-Jka and -K when he developed a delayed hemolytic transfusion reaction before allogeneic hematopoietic stem cell transplant (HSCT). Given that his stem cell donor was blood group O, D+, Jk(a+), K–, rituximab was added to his conditioning regimen of fludarabine and melphalan to prevent hemolysis of engrafting Jk(a+) donor red blood cells. The patient proceeded to receive a peripheral blood stem cell transplant from a
Miriam Y. Kim,
Preeti Chaudhary,
Ira A. Shulman,
Vinod Pullarkat
Immunohematology, Volume 29 , ISSUE 1, 11–14
Report | 16-March-2020
more. However, the lack of nucleic acid testing for HIV and HCV may be problematic for old RBC units drawn from donors who were not subsequently tested for these markers, which is now mandatory in most countries. Regarding the 118 transfused RBC units older than 10 years, no evidence of hemolysis of thawed RBCs and no transfusion reaction, clinical or biologic hemolysis, or transfusion ineffectiveness was reported, either by any of the parties involved in the transfusion supply of rare RBC units or
Thierry Peyrard,
Bach-Nga Pham,
Pierre-Yves Le Pennec,
Philippe Rouger
Immunohematology, Volume 25 , ISSUE 1, 13–17
Review | 16-October-2019
transfused antigenpositive red blood cells or a transfusion reaction (e.g., anti-P, anti-Jra, and anti-Lan), and/or hemolytic disease of the fetus and newborn (e.g., anti-RHAG4 and anti-Vel)—has been documented. For other antibodies, their prevalence is so rare that information on the clinical significance of their antibodies is not available (e.g., anti-FORS1).
Mostafa Moghaddam,
Amir Ali Naghi
Immunohematology, Volume 34 , ISSUE 3, 85–90
Report | 01-December-2019
difference in delayed or hemolytic transfusion reaction rates as this was not evaluated.
Anne Schmidt,
Brenda J. Bendix,
Eapen K. Jacob,
Sandra C. Bryant,
James R. Stubbs
Immunohematology, Volume 29 , ISSUE 3, 101–104
Case report | 01-December-2019
Hemolytic disease of the fetus and newborn (HDFN) owing to anti-U has rarely been reported. U is part of the MNS system. M and N glycoproteins are located on glycophorin A (GPA); S and s antigens are on glycophorin B (GPB). Individuals who lack GPB are S– and s– and also lack U. The U– phenotype occurs almost exclusively in the African population and has a very low frequency (0.25%). Anti-U is of immunoglobulin G class and can cause hemolytic transfusion reaction and HDFN. In
Johanna Strindberg,
Joachim Lundahl,
Gunilla Ajne
Immunohematology, Volume 29 , ISSUE 2, 51–54
Article | 10-November-2020
transfusing the patient. We report a case of warm autoimmune hemolytic anemia (WAIHA) in which the transfusion of red cells was complicated by a febrile transfusion reaction. Evaluation of the reaction resulted in a significant delay in transfusion therapy. Subsequent administration of leukocyte-poor red cells resulted in uneventful transfusions with a good therapeutic response. Retrospective analysis of the pretransfusion sample demonstrated significant levels of anti-neutrophil antibodies. This case
Jeanne A. Lumadue,
Rosetta Sue Shirey,
Thomas S. Kickler,
Paul M. Ness
Immunohematology, Volume 12 , ISSUE 2, 84–86
Article | 06-December-2020
A 62-year-old female with Gaucher's disease demonstrated alloanti-c on pretransfusion testing. She was transfused with five units of c-negative red blood cells (RBCs) preoperatively and intraoperatively. The hemoglobin (Hb) level was slightly lower initially, but was markedly lower on day 10 posttransfusion. Serologic results indicated a delayed hemolytic transfusion reaction (DHTR) due to alloanti-s, -Fya, and -Jkb, present both on the RBCs and in the serum. As late as day 35
Deborah L. Greene,
Sanobar Khan
Immunohematology, Volume 9 , ISSUE 3, 74–77
Case Study | 16-May-2020
Hyung Hoi Kim,
Tae Sung Park,
Seung Hwan Oh,
Chulhun L. Chang,
Eun Yup Lee,
Han Chul Son
Immunohematology, Volume 20 , ISSUE 3, 184–186
Case report | 14-December-2020
Christopher D. Hillyer,
Jacquelynn M. Hall,
Karen O. Tiegerman,
Eugene M. Berkman
Immunohematology, Volume 7 , ISSUE 4, 102–106
Review | 16-October-2019
survival of transfused antigen-positive red blood cells or a transfusion reaction (e.g., anti-Ge2, anti-H) and/or hemolytic disease of the fetus and newborn (e.g., anti-Coa , anti-Ge3)— has been documented. Some of these antibodies are not always clinically significant, and because of the high prevalence of the antigen, antigen-negative blood may be extremely difficult to find (e.g., anti-LW, anti-Inb). The use of a monocyte monolayer assay may be helpful when making transfusion decisions for
Sofia Lejon Crottet
Immunohematology, Volume 34 , ISSUE 3, 103–108
Review
cancer progression, the significance in transfusion medicine is limited to one report of a hemolytic transfusion reaction in Subject 5.
Michele Hayes
Immunohematology, Volume 30 , ISSUE 1, 6–10
Article | 30-November-2020
A patient was transfused with a total of 14 units of red blood cells (RBCs) over 33 days (January 14 to February 15) at two hospitals. Febrile transfusion reactions were noted on three occasions, and hemoglobinuria was seen twice. Alloantibodies were not detected in a sample dated February 14, following a transfusion reaction, and this sample was referred to the North London Blond Transfusion Centre. Further samples were also obtained from before and after all transfusions at both hospitals
Alan Devenish,
Lesley A. Kay
Immunohematology, Volume 10 , ISSUE 4, 120–123
Review | 01-December-2019
is generally a weak and cold-reactive antibody not implicated in hemolytic transfusion reaction (HTR) or hemolytic disease of the fetus and newborn while Pk antibodies can cause HTR, and anti-NOR is regarded as a polyagglutinin. A higher frequency of miscarriage is seen in women with the rare phenotypes p, P1k, and P2k. Furthermore, the Pk and P1 antigens have wide tissue distributions and can act as host receptors for various pathogens and toxins. Why p individuals lack not only Pk and P
Åsa Hellberg,
Julia S. Westman,
Britt Thuresson,
Martin L. Olsson
Immunohematology, Volume 29 , ISSUE 1, 25–33
Review | 28-April-2020
. In addition, it will be shown in an in vivo mouse model of transfusion reaction that recombinant soluble forms of CR1 can reduce complement-mediated RBC destruction,thereby prolonging survival of transfused RBCs. It is proposed that CR1-based therapeutics have potential for effective and safe prophylactic short-term use and for treatment of hemolytic transfusion reactions.
Karina Yazdanbakhsh
Immunohematology, Volume 21 , ISSUE 3, 109–118
Article | 03-November-2020
were most commonly referred from departments investigating possible immunodeficiency and suspected transfusion reactions. Of 247 patients investigated, 122 had IgA deficiency, 43 with anti-IgA (of whom 5 had suffered a transfusion reaction). Donors and patients with antiIgA were issued blood group cards warning that they should only receive IgA deficient products.
R. Munks,
J.R. Booth,
R.J. Sokol
Immunohematology, Volume 14 , ISSUE 4, 155–160
Article | 17-November-2020
during the exchange consisted first of one unit of group B, D+, AS-1 packed red blood cells (RBCs), resuspended in group AB fresh frozen plasma (FFP), followed by one unit of group O, D-, CPDA-1 RBCs resuspended in group AB FFP. During the second infusion, the infant displayed an increase in temperature and hemoglobinuria, characteristics consistent with an acute intravascular hemolytic transfusion reaction. Clerical errors and hemolysis due to polyagglutinable infant RBCs were ruled out. Further
Gregg Boothe,
Mark E. Brecher,
Mamie B. Root,
Judy Robinson,
Nancy R. Haley
Immunohematology, Volume 11 , ISSUE 2, 43–45
Article | 17-November-2020
This study compared the performance of polyethylene glycol (PEG) and low-ionic saline solutions (LISS) as enhancement media for routine use in a large transfusion service. A PEG additive solution (PEG plus LISS) was compared to a LISS additive (LISS plus polymers) and to an albumin-indirect antiglobulin test (A-IAT). Fifty serum samples containing clinically significant alloantibodies and fifty samples without alloantibodies were tested. Following an acute hemolytic transfusion reaction (HTR
Vicki J. Barrett,
James R. Stubbs,
Karen Stuardi,
Angela Hollis,
Leslie Clear
Immunohematology, Volume 11 , ISSUE 1, 11–13
Article | 30-November-2020
Type, Bristol, UK, maintained by the World Health Organization. Four units of group O, K:4, E-, S- RBCs were transfudes in the next 24 hours while the K:-4 blood was in transit. No immediate signs of a transfusion reaction were noted. Blood pressure, temperature, bilirubin, and urinary output were normal, and an increase in hemoglobin was observed. A positive direct antiglobulin test was evident 3 days posttransfusion of the incompatible units and was still present 8 days later. Anti-A and anti-K4
Julie M Watt,
Peter N. Moffatt,
Suzanne Y. Chatfield,
Wendy A. Grimm,
Jennifer A. Bryant
Immunohematology, Volume 10 , ISSUE 3, 87–89
Article | 17-February-2021
RBC or pregnancy sensitization. The absence of all three antigens leads to the rare p phenotype and the production of the mixture component antibody, anti-PP1Pk.2,3 This antibody is often associated with hemolytic transfusion reaction (HTR), hemolytic disease of the fetus and newborn (HDFN), and spontaneous abortion in early pregnancy.4
Anti-PP1Pk has been found to be a mixture of IgM and IgG isotypes and able to react over a wide range of temperatures and potentially bind and activate complement
K. Intharanut,
W. Sasikarn,
W. Chusri,
O. Nathalang
Immunohematology, Volume 36 , ISSUE 2, 64–68
Article | 14-October-2020
Tetsunori Tasaki,
Kieko Fujii,
Kenji Gotoh,
Shyukuko Satoh,
Jyunko Takadate,
Sakiko Sasaki,
Mihoko Tachibana,
Kimiko Yamamoto
Immunohematology, Volume 18 , ISSUE 4, 104–108
Case report
Shaina McCaskill,
Scott Wise,
Sheila Tinsley
Immunohematology, Volume 31 , ISSUE 3, 119–122