@article {4245,
	title = {An acute hemolytic transfusion reaction caused by an anti-P1 that reacted at 37 degrees C.},
	journal = {Transfusion//Transfusion},
	volume = {38},
	year = {1998},
	month = {1998},
	pages = {373 - 7},
	publisher = {Arndt,P A. American Red Cross Blood Services, Southern California Region, Los Angeles, USA.},
	address = {UNITED STATES},
	abstract = {BACKGROUND: Hemolytic transfusion reactions (HTRs) due to anti-P1 have rarely been reported. There is only one report (from 1945) of an acute HTR due to anti-P1., CASE REPORT: A 74-year-old woman with anti-P1 was given blood that had been found to be compatible by the use of prewarmed serum and saline-suspended red cells (RBCs) and of an antiglobulin test with anti-IgG. The test mixtures were not centrifuged or inspected for agglutination after the 37 degrees C incubation phase. After transfusion of 50 mL of P1 + blood, the patient had an acute HTR (hemoglobinemia, hemoglobinuria, and increased blood pressure, temperature, and respiration)., RESULTS: When studied by a reference laboratory, the anti-P1 was shown to be easily detectable (3+ agglutination) by a prewarming technique (saline or low-ionic-strength saline [LISS]), which included centrifugation at 37 degrees C, but only weak reactions were observed when centrifugation after 37 degrees C incubation was omitted. The indirect antiglobulin test was weakly positive (1+) with anti-IgG, but polyspecific anti-human globulin reacted 2+. The anti-P1 agglutinin was IgM, and its titer was 16 at 37 degrees C (prewarmed) and 256 at 23 degrees C; it caused hemolysis of RBCs at 37 degrees C under conditions known to enhance hemolysis. An indirect monocyte monolayer assay gave results of 11.2 and 22 percent in testing of P1 + RBCs incubated with the patient{\textquoteright}s serum alone and with patient{\textquoteright}s serum plus fresh normal serum (as a source of complement), respectively (normal < or = 3\%)., CONCLUSION: An acute HTR was caused by a hemolytic anti-P1 that reacted at 37 degrees C. This antibody was not detected by the hospital in a prewarmed crossmatch that omitted 1) the addition of LISS, 2) the reading for agglutination after the 37 degrees C incubation, and 3) the use of antiglobulin sera containing anti-complement.},
	keywords = {*Blood Group Incompatibility/co [Complications], *Blood Transfusion/ae [Adverse Effects], *Hemolysis, *P Blood-Group System, Acute Disease, Aged, Blood Grouping and Crossmatching, Female, Humans, Immunoglobulin G/bl [Blood], Immunoglobulin M/bl [Blood], Mercaptoethanol, Osmolar Concentration, Temperature, Titrimetry},
	isbn = {0041-1132},
	author = {Arndt, P A and Garratty, G and Marfoe, R A and Zeger, G D}
}
