|Title||Acute hemolytic transfusion reaction due to a warm reactive anti-A1|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Helmich F, Baas I, Ligthart P, Bosch M, Jonkers F, de Haas M, F va|
This is a case report of a 96-year-old woman who died shortly after transfusion of blood group A red blood cells (RBCs). She was known to have blood group A2 with an anti-A1 and the absence of other RBC antibodies. Directly after starting transfusion, acute dyspnea was observed, while other clinical signs for a transfusion reaction were absent. In the laboratory, indications for a severe hemolytic transfusion reaction (HTR) triggered serologic investigations and complement deposition experiments.
Analyses revealed that the anti-A1 was present as a high-titer IgM class immunoglobulin that induced complement deposition on A1 RBCs. The anti-A1 reacted in a wide temperature amplitude up to 37°C with A1 RBCs, while weak agglutination was observed with A2 RBCs at room temperature.
A pretransfusion detectable anti-A1 caused a severe HTR that, in view of the rapid onset of clinical symptoms and concomitant deterioration, contributed to the death of the patient. Considering its clinical significance in this case, we encourage an unambiguous procedure for patients with an anti-A1 , especially when T&S is used for donor RBC selection.
|Notify Library Reference ID||4692|