Delayed Hemolytic Transfusion Reaction (DHTR), anti-Dombrock, anti-Do(b)

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
5-8 days
Alerting signals, symptoms, evidence of occurrence: 
Following 6 units of whole blood, the patient's hemoglobin concentration declined from 12.0 g per dl on the 5th postoperative day to 7.2 g per dl on the 14th day. On day 8 the lactic acid dehydrogenase level was 1480 IU (normal 115-200 lU/l); the total serum bilirubin was I .4 mg per dl, A screening haptoglobin was low.
Demonstration of imputability or root cause: 
She had anti-Do(b) in both serum and eluate 8 days after infusion of 6 units of Do(b+) red cells. No antibody had been detected prior to transfusion. By the 15th day after transfusion there was no evidence of survival of red cells from any of the 6 units. Anti-C and anti-M were demonstrated later, but 29 months after transfusion, no atypical antibodies were detectable.
Imputability grade: 
2 Probable
Groups audience: 
Suggest new keywords: 
anti-Dombrock, anti-Do(b), lactic acid dehydrogenase
Reference attachment: 
Suggest references: 
Moheng, MC, McCarthy, P and Pierce, SR. (1985). Anti-Dob implicated as the cause of a delayed hemolytic transfusion reaction. Transfusion 25:44-6.
Expert comments for publication: 
Dombrock antibodies, anti-Do(a) and -Do(b), have been responsible for immediate and delayed hemolytic transfusion reactions.