02511nas a2200181 4500008004100000020001400041024001700055245006000072210005600132260028100188300001300469490000700482520173200489100002402221700002202245700001702267856004502284 2015 eng d a1537-2995 awdn, 041736000aAcute hemolytic transfusion reaction due to anti-Le(b).0 aAcute hemolytic transfusion reaction due to antiLeb aUnited StatesbIrani,Mehraboon S. Immunohematology Reference Laboratory, Blood Systems Laboratories, Tempe, Arizona.Figueroa,Dolores. Immunohematology Reference Laboratory, Blood Systems Laboratories, Tempe, Arizona.Savage,Gail. Immunohematology Reference Laboratory, Blc2015 a2486 - 80 v553 a
BACKGROUND: Anti-Le(b) is usually a clinically insignificant antibody of immunoglobulin M subclass most often found in the sera of pregnant women or individuals that are Le(a-b-). We report a case of an acute hemolytic transfusion reaction due to a hemolytic anti-Le(b) that was not seen in the pretransfusion antibody detection test, but was strongly reactive in posttransfusion testing., CASE REPORT: A 30-year-old African-American woman with metastatic renal cell carcinoma was receiving chemotherapy. She was anemic with hemoglobin (Hb) of 7.2 g/dL and had a negative antibody detection test by the solid-phase red blood cell adherence method. She was transfused with 2 RBC units without incident. Nine days later her Hb was 7.9 g/dL again with a negative antibody detection test. Transfusion of an additional RBC unit was begun. During the transfusion she developed chills, nausea, hypertension, and red-brown urine. The posttransfusion sample plasma was grossly hemolyzed with a strongly positive direct antiglobulin test (DAT) by gel. By comparison the pretransfusion plasma was normal appearing and the DAT was weaker. The eluate was negative on both occasions. Anti-Le(b) was detected in the posttransfusion sample by MTS gel (Ortho Diagnostics). Both RBC units she had received before the RBC unit that caused the reaction were Le(b+) as was the implicated RBC unit., CONCLUSION: This case illustrates that anti-Le(b) which is usually clinically insignificant can occasionally cause severe hemolytic transfusion reactions. Only three other reported cases of anti-Le(b) causing hemolytic transfusion reactions could be found in the literature, two of which were in abstract form only.Copyright © 2015 AABB.
1 aIrani, Mehraboon, S1 aFigueroa, Dolores1 aSavage, Gail uhttps://notifylibrary.org/reference/4449