Status:
Ready to upload
Record number:
1225
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Case Report
Time to detection:
5 days
Alerting signals, symptoms, evidence of occurrence:
Fever, back and left upper quadrant abdominal pain, dark brown urine. Indirect antiglobulin tests enhanced by polyethylene glyocol revealed a weak reactive anti-Js(a).
Demonstration of imputability or root cause:
The positive DAT, eluate results, and supporting laboratory value are the key serologic tests that implicate a serologic reaction, while correlated clinical symptoms in the patient support a hemolytic reaction. The patient was a 62-year-old-black woman A, Rh-positive in whom multiple alloantibodies were identified during the compatibility testing procedures (anti-E, -M, -Fya, -Jkb) performed for a total elective thyroidectomy. To prepare the patient for surgery a simple partial manual exchange to remove one unit and replace it with two units of RBCs that were negative for E, M, Fya, and Jkb antigens. Five days after the exchange a severe DHTR was observed. An anti-Jsa was detected. This antibody could be detected in the previous screen by using PEG.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
"DHTR, alloimmunization, SCD, red blood cell transfusion."
Reference attachment:
Suggest references:
Anderson, R.R., Sosler, S.D., Kovach, J. and DeChristopher, P.J. (1997). Delayed hemolytic transfusion reaction due to anti-Js(a) in an alloimmunized patient with a sickle cell syndrome. Am J Clin Pathol 108(6):658-661.
Expert comments for publication:
The patient was a 62-year-old-black woman A, Rh-positive in whom multiple alloantibodies were identified during the compatibility testing procedures (anti-E, -M, -Fya, -Jkb) performed for a total elective thyroidectomy. To prepare the patient for surgery a simple partial manual exchange to remove one unit and replace it with two units of RBCs that were negative for E, M, Fya, and Jkb antigens. Five days after the exchange a severe DHTR was observed. An anti-Jsa was detected. This antibody could be detected in the previous screen by using PEG (polyethylene glycol).