Delayed Hemolytic Transfusion Reaction (DHTR), anti-s

Status: 
Ready to upload
Record number: 
1207
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Kalyanaraman et al: case Report
Time to detection: 
8 days
Alerting signals, symptoms, evidence of occurrence: 
Severe anemia, signs and symptoms similar to vaso-occlusive crisis in patient with sicle cell disease and apparently similar presentation in a patient without hemoglobinopathy. Both cases reflect presentations seen with "hyperhemolysis" syndrome.
Demonstration of imputability or root cause: 
Case reports, clinical situation consistent with persistent hemolysis.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
delayed hemolytic transfusion reaction; hyperhemolysis syndrome
Suggest references: 
Kalyanaraman, M., Heidemann, S.M., Sarnaik, A.P., Meert, K.L. and Sanaik, S.A. (1999). Anti-s antibody-associated delayed hemolytic transfusion reaction in patients with sickle cell anemia. J Pediatr Hematol Oncol 21(1):70-73; Gupta, S., Fenves, A., Nance, S.T., Sykes, D.B. and Dzik, W.S. (2014). Hyperhemolysis syndrome in a patient without a hemoglobinopathy, unresponsive to treatment with eculizumab. Transfusion DOI: 10.1111/trf.12876.
Note: 
first case may not represent hyperhemolysis
Expert comments for publication: 
The antibodies of the MNS system to glycophorin B, anti-S, -s, and -U can all cause immediate and delayed hemolytic transfusion reactions, and anti-U is a particularly dangerous antibody.