Status:
Ready to upload
Record number:
1244
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Rare. This is the first known reported case of an AHTR caused by anti-Co(a).
Time to detection:
60 minutes
Alerting signals, symptoms, evidence of occurrence:
A 58-year old man was hospitalized for vascular surgery. In the pretransfusion sample anti-E, anti-Fya, a cold autoantibody, and an apparent warm autoantibody were detected. During surgery the patient was transfused with one "least-incompatible" unit (E-, Fya-, K- and Jka-). In the post-anesthesia recovery unit, within 60 minutes from the start of the transfusion, the patient was noted to develop rigors, increased temperature, and hemoglobinuria. The hematocrit was also noted to have decreased.
Demonstration of imputability or root cause:
Following transfusion of an incompatible unit, the patient developed signs and symptoms suggestive of an AHTR, including a positive direct antiglobulin test (DAT). A panel of RBCs to test for the presence of antibodies to high-frequency antigens demonstrated anti-Co(a). A post-transfusion sample revealed a new anti-Jka. The patient's RBCs were Co(a-) and Jk(a-). Because Co(a-), Jk(a+) cells did not show agglutination during repeat testing of the pre-transfusion sample, it is highly likely the reaction was caused by anti-Co(a).
Imputability grade:
2 Probable
Groups audience:
Keywords:
Suggest new keywords:
Colton, anti-Co(a), anti-E, anti-Fy(a), high frequency antigens, high incidence antigens
Reference attachment:
Suggest references:
Covin, R.B., Evans, K.S., Olshock, R. and Thompson, H.W. (2001). Acute hemolytic transfusion reaction caused by anti-Coa. Immunohematology 17(2):45-49.
Expert comments for publication:
This is the first known reported case of AHTR caused by anti-Co(a). Anti-Co(a) causes acute and delayed hemolytic transfsuion reactions (HTRs). Anti-Co(b) and -Co(3) have caused mild HTRs. Co(a) is a high incidence antigen.