@article {4737,
	title = {The first case of severe acute hemolytic transfusion reaction caused by anti-Sc2},
	volume = {58},
	year = {2018},
	month = {Nov},
	pages = {06},
	abstract = {BACKGROUND:

Alloantibodies to the low-frequency antigen Scianna-2 (Sc2) have been implicated in cases of hemolytic disease of the fetus and newborn but never in hemolytic transfusion reactions (HTRs); thus, the clinical significance of anti-Sc2 has yet to be fully addressed.
STUDY DESIGN AND METHODS:

A 26-year-old woman with thalassemia presented rigors, fever, nausea, abdominal pain, and hemolytic biochemistry after exposure to 75 mL of plasma-reduced red blood cells (RBCs). The RBC unit was issued by electronic crossmatch but was 3+ incompatible on recrossmatch by gel indirect antiglobulin test (IAT). The patient had anti-Sc2 previously identified, but considered to be clinically insignificant. The transfusion history was reviewed and a monocyte monolayer assay (MMA) was performed.
RESULTS:

The patient was investigated for a RBC reaction 9 years prior, when she developed symptoms of HTR. The RBC unit was crossmatched by immediate spin due to consistent screen negativity. Full crossmatch found the RBC 1+ incompatible by gel IAT with both pre/post samples, while direct antiglobulin test was negative (pre) and 1+ immunoglobulin G positive (post). The antibody remained unidentified and she was committed to gel IAT crossmatch. Two-years later, the specificity to Sc2 was deduced when one RBC unit was found 3+ incompatible. Finally, the transfusion reaction reported herein occurred when she received by happenstance RBCs from the same donor who was associated with the remote reaction 9 years earlier. MMA yielded highly positive phagocytic indices only for Sc2+ RBCs, including the donor{\textquoteright}s RBCs that triggered the severe HTR.
CONCLUSION:

This is the first case of HTR caused by anti-Sc2 confirmed by clinical findings and MMA.},
	doi = {10.1111/trf.14867},
	author = {Lemay, AS and Tong, TN and Branch, DR and Huang, M and Sumner, C and Oldfield, L and Hawes, J and Cserti-Gazdewich, CM and Lau, W}
}
