Status:
Ready to upload
Record number:
1222
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Ipe: Case Report
Time to detection:
10 days
Alerting signals, symptoms, evidence of occurrence:
Bilateral leg and abdominal pain, dark urine and fatigue. Hemoglobin of 5.6, reticulocyte count 12.8%, unconjugated bilirrubin 5.6 mg/dL (normal range, 0, 2 to 1,0 mg/dL), and lactate dehydrogenase 7820 U/L (normal range 470 to 900 U/L) in a 5-year-old male with sickle-cell disease who typed as D positive, but developed a severe DHTR due to anti-D following transfusion of one unit of D+ red blood cells.
Demonstration of imputability or root cause:
The typical clinical signs and symptoms and the laboratory data of a DHTR were present. Hyperhemolysis was excluded and no other causes explaining the hemolytic reactions were present. Molecular studies revealed homozygositiy for RHD*DAU4, a known partial D allele. This strongly suggests that the anti-D was an alloantibody formed after transfusion with D+ red blood cells that express D epitopes that the patient lacks.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
References:
Suggest new keywords:
anti-D,
Reference attachment:
Suggest references:
Ipe, T.S., Wilkes, J.J., Hartung, H.D., Westoff, C.M., Chou, S.T. and Friedman, D.F. (2014). Severe Hemolytic Transfusion Reaction Due to Anti-D in a D+ Patient With Sickle Cell Disease. J Pediatr Hematol Oncol 37(2): e135-137. DOI:10.1097/MPH.0000000000000241.