02378nas a2200229   4500008003900000245008500039210006900124260000800193300000700201490000700208520175400215100001401969700001301983700001501996700001302011700001402024700001602038700001302054700002502067700001102092856004502103       2018                          d00aThe first case of severe acute hemolytic transfusion reaction caused by anti-Sc20 afirst case of severe acute hemolytic transfusion reaction caused  cNov  a060 v583 aBACKGROUND:

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'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.1 aLemay, AS1 aTong, TN1 aBranch, DR1 aHuang, M1 aSumner, C1 aOldfield, L1 aHawes, J1 aCserti-Gazdewich, CM1 aLau, W  uhttps://notifylibrary.org/reference/4737