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  • Immunohematology

 

Case report | 09-October-2019

Acute hemolytic transfusion reaction attributed to anti-Ata

Anti-Ata is a rare alloantibody that can be clinically significant. We report a case of a woman who, after emergency-released uncrossmatched red blood cell transfusion, experienced an acute hemolytic transfusion reaction attributed to anti-Ata. The case presented herein highlights the importance of recognizing that anti-Ata may indeed cause acute hemolytic reactions.

Jay S. Raval, Sarah K. Harm, Bethann Wagner, Darrell J. Triulzi, Mark H. Yazer

Immunohematology, Volume 32 , ISSUE 4, 140–142

Case report | 11-March-2020

An unusual case of an acute hemolytic transfusion reaction caused by an autoanti-I

In general, naturally occurring cold autoagglutinins react optimally at low temperatures. We describe a young child who experienced an acute hemolytic transfusion reaction by an unusual autoanti-I. The IgM autoanti-I was detected at 4°C (titer 256) and also reacted at 30°C. This case highlights the potential hazard of transfusing units of blood immediately upon removal from the blood refrigerator, especially into neonates and children of small stature.

Nay Win, Sally Rahman, Philip Gold, Susan Ward

Immunohematology, Volume 27 , ISSUE 3, 101–103

Case report | 24-March-2020

Overt immediate hemolytic transfusion reaction attributable to anti-Wra

Wra is a low-prevalence antigen.  Anti-Wra is a relatively common antibody present in approximately 1 in 100 healthy blood donors.  Anti-Wra is reported to cause different degrees of hemolysis in transfusion and in HDN, ranging from benign to severe.  This report describes an acute overt hemolytic transfusion reaction in a patient whose serum contained anti-Wra and who received a Wr(a+) RBC component.

Fouad N. Boctor

Immunohematology, Volume 24 , ISSUE 3, 113–115

Article | 16-February-2021

Dilution is not the solution: acute hemolytic transfusion reaction after ABO-incompatible pooled platelet transfusion

allow ABO-incompatible platelets to be issued to adult patients, and up to 40 percent of platelets issued are incompatible.3,4 The major risk associated with this practice is an acute hemolytic transfusion reaction (AHTR), typically due to minor ABO incompatibility in which donor antibodies hemolyze recipient red blood cells (RBCs). The most common scenario involves a group A recipient receiving a platelet unit obtained via apheresis from a group O donor who has a high anti-A titer.2 As seen in the

J. Guarente, M. Harach, J. Gould, J.K. Karp, A.R. Peedin

Immunohematology, Volume 35 , ISSUE 3, 91–94

Article | 10-April-2021

Acute hemolytic transfusion reaction caused by anti-Yta

patient with an acute hemolytic transfusion reaction (AHTR) after the transfusion of 1 crossmatch-incompatible Yt(a+) RBC unit. Case Report In 2016, an 83-year-old white female patient of Croatian ancestry was admitted to the hospital with hematemesis from a duodenal ulcer. The patient’s hospital admission was attributed to poorly controlled anticoagulant therapy for the management of deep venous thrombosis, which previously led to cerebral infarction. Admission hemoglobin (Hb) was 6.6 g/dL and

M. Raos, N. Thornton, M. Lukic, B. Golubic Cepulic

Immunohematology, Volume 37 , ISSUE 1, 13–17

Article | 10-April-2021

A fatal case of acute hemolytic transfusion reaction caused by anti-Wra: case report and review of the literature

delayed hemolytic transfusion reaction (DHTR) caused by anti-Wra, were reported in the annual report26 for 2017, and three cases of DHTR were reported in the 2019 annual report.27 In the Norwegian hemovigilance system28 Troll, two cases of acute HTRs due to anti-Wra have been reported since 2004, in addition to the one described in this case report. Neither of the two previous cases had a fatal outcome. The case described here presents an opportunity to remind clinicians of the risks of RBC

A. Espinosa, L.J. Garvik, N. Trung Nguyen, B. Jacobsen

Immunohematology, Volume 37 , ISSUE 1, 20–24

Case report | 09-October-2019

A suspected delayed hemolytic transfusion reaction mediated by anti-Joa

, was transfused. The following day, her Hb was unchanged, lactic acid dehydrogenase increased from 951 to 2464 U/L, potassium increased from 3.7 to 4.6 mEq/L, creatinine increased from 0.60 to 0.98 mg/dL, and the patient developed a 38.4°C fever. These findings are consistent with a delayed hemolytic transfusion reaction (DHTR), mediated by anti-Joa, occurring 2 weeks after the first RBC transfusion. Further care could not be provided because the patient left the hospital against medical advice

Ryan P. Jajosky, Wendy C. Lumm, Scott C. Wise, Roni J. Bollag, James F. Shikle

Immunohematology, Volume 33 , ISSUE 2, 73–75

Case report | 16-October-2019

A delayed and acute hemolytic transfusion reaction mediated by anti-c in a patient with variant RH alleles

RHCE*ceEK/ RHCE*ceAR alleles. The patient was previously alloimmunized to D, C, and E and possibly hrS. Further transfusion of D–C–E–K– RBCs resulted in a suspected acute hemolytic transfusion reaction and the subsequent identification of anti-c. Monocyte monolayer assay testing suggests clinical significance with a range of 29.5–38.5 percent reactive monocytes.

Tiffany K. Walters, Thomas Lightfoot

Immunohematology, Volume 34 , ISSUE 3, 109–112

Article | 14-October-2020

Fatal hemolytic transfusion reaction due to anti-Ku in a Knull patient

Marie Lin, Chang Lin Wang, Fu-Sen Chen, Li-Hwa Ho

Immunohematology, Volume 19 , ISSUE 1, 19–21

Article | 21-April-2020

Acute hemolytic transfusion reaction secondary to anti-Fy3

A hemolytic transfusion reaction due to anti-Fy3 is reported in an African American patient with no history of sickle cell disease. This 82-year-old African American woman received two units of RBCs for anemia (Hb 7g/dL) on admission for a left hip fracture. On hospital Day 7, the patient underwent left hip endoprosthesis surgery; she received two units of RBCs on the second postoperative day due to Hb of 6.1g/dL. Her urine was dark during surgery and postoperatively. Her posttransfusion plasma

Horatiu Olteanu, David Gerber, Kara Partridge, Ravindra Sarode

Immunohematology, Volume 21 , ISSUE 2, 48–52

Case report | 09-October-2019

Hemolytic transfusion reaction attributable to anti-Dia  

In situations when a patient's antibody detection test is negative, many institutions have moved from an indirect antiglobulin test (IAT) crossmatch to an electronic crossmatch system. Here we report a case of an acute hemolytic transfusion reaction attributable to anti-Dia in a patient with a negative antibody detection test. A 22-year-old female patient with a diagnosis of β thalassemia and sickle cell anemia commenced a routine exchange transfusion of 5 units of red blood cells

Arthur J. Joyce, Kelli M Quantock, Ray Banh, Yew-Wah Liew

Immunohematology, Volume 33 , ISSUE 1, 6–8

Case report | 27-April-2020

Case report: massive postpartum transfusion of Jr(a+) red cells in the presence of anti-Jra

,she did not develop laboratory or clinical evidence of acute hemolysis. The patient’s anti-Jra had a pretransfusion titer of 4 and a monocyte monolayer assay (MMA) reactivity of 68.5% (reactivity > 5% is considered capable of shortening the survival of incompatible RBCs). The titer increased fourfold to 64 and the MMA reactivity was 72.5% on Day 10 posttransfusion. Review of laboratory data showed evidence of a mild delayed hemolytic transfusion reaction by Day 10 posttransfusion. Despite

Shan Yuan, Rosalind Armour, Allison Reid, Khaled F. Abdel-Rahman, Michael Phillips, Dawn M. Rumsey, Theresa Nester

Immunohematology, Volume 21 , ISSUE 3, 97–101

Article | 09-November-2020

Delayed hemolytic transfusion reaction and paroxysmal cold hemoglobinuria: an unusual association

. It was thought that the original low titer of anti-A reflected compromised immune homeostasis in an elderly patient and that stimulation by incompatible blood in those circumstances resulted in a delayed hemolytic transfusion reaction that triggered, exacerbated, or was accompanied by an autoimmune response manifesting as PCH.

M.A. Wodzinski, R.C. Collin, D.J. Booker, R. Stamps, J.D. Bellamy, R.J. Sokol

Immunohematology, Volume 13 , ISSUE 2, 54–57

Article | 14-October-2020

Acute hemolytic transfusion reaction caused by anti-Coa

Randal B. Covin, Karen S. Evans, Richard Olshock, Hannis W. Thompson

Immunohematology, Volume 17 , ISSUE 2, 45–49

Case report | 17-March-2020

Anti-Kpa–induced severe delayed hemolytic transfusion reaction

Ranie Koshy, Bhishma Patel, Jonathan S. Harrison

Immunohematology, Volume 25 , ISSUE 2, 44–47

Case report | 26-October-2019

Suspected acute hemolytic transfusion reaction mediated by anti-Dia

Ashwini Bennett, Ray K. Boyapati, Frank S. Hong

Immunohematology, Volume 31 , ISSUE 4, 163–165

Case report | 20-December-2020

A case report: clinically benign anti-Csa

Previous reports on the clinical significance of anti-Csa(Cost-Stirling) have presented conflicting data. We report our findings, over an 8-month period, of a patient whose serum contained anti-Csa and anti-Fya. Nineteen donor units of ABO and Rh-matched, Fya-negative red cells, which were crossmatch incompatible, were transfused with no clinical, serological, or biochemical evidence of a hemolytic transfusion reaction.

Thom Sererat, Jan Alexander, Jack Beatty

Immunohematology, Volume 6 , ISSUE 3, 71–72

Article | 10-November-2020

Severe intravascular hemolysis due to autoantibodies stimulated by blood transfusion

Autoantibodies may cause severe hemolytic anemia, but only rarely are they the cause of a hemolytic transfusion reaction due to the destruction of transfused allogeneic blood. In two patients, autoantibody was detected shortly after blood transfusion. The first case was a D-negative patient who produced an autoanti-Ce and subsequently developed hemoglobinuria and hyperbilirubinemia. The second case was a patient who developed an autoanti-Wrb that caused severe hemolysis that resulted in death.

D. Chan, G.D. Poole, M. Binney, M.D. Hamon, J.A. Copplestone, A.G. Prentice

Immunohematology, Volume 12 , ISSUE 2, 80–83

Case report | 06-December-2020

Immune-mediated hemolysis in a postoperative patient Case report: anti-U and differential diagnosis

We present the differential diagnosis for a Coombs-positive immune hemolysis having onset during hospitalization and, in particular, during the postoperative period. The stimulus for this article was a delayed hemolytic transfusion reaction (DHTR) due to anti-U following open-heart surgery. The initial clinical and serologic findings led us to consider other causes of immune hemolysis which are reviewed in this article. To our knowledge, this is the fourth case of a DHTR due to anti-U to be

Gnanasagren Sathaseevan Pillay, Betty Womack, S. Gerald Sandler

Immunohematology, Volume 9 , ISSUE 2, 41–46

Review | 16-October-2019

Clinical significance of antibodies to antigens in the International Society of Blood Transfusion collections, 700 series of low-incidence antigens, and 901 series of high-incidence antigens

This article reviews information regarding the clinical significance of antibodies to antigens in the blood group collections, the 700 series of low-incidence antigens, and the 901 series of high-incidence antigens. Antibodies to many of the antigens in these groups are rarely encountered, meaning that available information is limited. For a few, the clinical significance— the potential to cause reduced survival of transfused antigen-positive red blood cells, a hemolytic transfusion

Christine Lomas-Francis

Immunohematology, Volume 34 , ISSUE 2, 39–45

Article | 03-November-2020

GIL: a red cell antigen of very high frequency

disease. Anti-GIL may have been responsible for a hemolytic transfusion reaction and results of monocyte monolayer assays of two of the anti-GIL suggested a potential to cause destruction of transfused GIL+ RBCs.

Geoff Daniels, E. Nicole DeLong, Virginia Hare, Susan T. Johnson, Pierre-Yves LePennec, Delores Mallory, M. Jane Marshall, Cindy Oliver, Peggy Spruell

Immunohematology, Volume 14 , ISSUE 2, 49–52

Letter | 14-October-2020

Letter to the Editors: A hemolytic transfusion reaction due to anti-K undetected by a LISS antibody screen

Mark T. Friedman, Alan P. Carioti

Immunohematology, Volume 17 , ISSUE 3, 90–91

Case report | 01-December-2019

Major non-ABO incompatibility caused by anti-Jka in a patient before allogeneic hematopoietic stem cell transplantation

A 49-year-old white man with blood group AB, D+ was found to have alloanti-Jka and -K when he developed a delayed hemolytic transfusion reaction before allogeneic hematopoietic stem cell transplant (HSCT). Given that his stem cell donor was blood group O, D+, Jk(a+), K–, rituximab was added to his conditioning regimen of fludarabine and melphalan to prevent hemolysis of engrafting Jk(a+) donor red blood cells. The patient proceeded to receive a peripheral blood stem cell transplant from a

Miriam Y. Kim, Preeti Chaudhary, Ira A. Shulman, Vinod Pullarkat

Immunohematology, Volume 29 , ISSUE 1, 11–14

Report | 01-December-2019

Single-center comparison of gel microcolumn and solid-phase methods for antibody screening

difference in delayed or hemolytic transfusion reaction rates as this was not evaluated.

Anne Schmidt, Brenda J. Bendix, Eapen K. Jacob, Sandra C. Bryant, James R. Stubbs

Immunohematology, Volume 29 , ISSUE 3, 101–104

Case report | 01-December-2019

Hemolytic disease of the fetus and newborn owing to anti-U, successfully treated with repeated intrauterine transfusions

Hemolytic disease of the fetus and newborn (HDFN) owing to anti-U has rarely been reported. U is part of the MNS system. M and N glycoproteins are located on glycophorin A (GPA); S and s antigens are on glycophorin B (GPB). Individuals who lack GPB are S– and s– and also lack U. The U– phenotype occurs almost exclusively in the African population and has a very low frequency (0.25%). Anti-U is of immunoglobulin G class and can cause hemolytic transfusion reaction and HDFN. In

Johanna Strindberg, Joachim Lundahl, Gunilla Ajne

Immunohematology, Volume 29 , ISSUE 2, 51–54

Article | 06-December-2020

Reactive lysis - a phenomenon of delayed hemolytic transfusion reactions

A 62-year-old female with Gaucher's disease demonstrated alloanti-c on pretransfusion testing. She was transfused with five units of c-negative red blood cells (RBCs) preoperatively and intraoperatively. The hemoglobin (Hb) level was slightly lower initially, but was markedly lower on day 10 posttransfusion. Serologic results indicated a delayed hemolytic transfusion reaction (DHTR) due to alloanti-s, -Fya, and -Jkb, present both on the RBCs and in the serum. As late as day 35

Deborah L. Greene, Sanobar Khan

Immunohematology, Volume 9 , ISSUE 3, 74–77

Case Study | 16-May-2020

Delayed hemolytic transfusion reaction due to anti-Fyb caused by a primary immune response: a case study and a review of the literature

Hyung Hoi Kim, Tae Sung Park, Seung Hwan Oh, Chulhun L. Chang, Eun Yup Lee, Han Chul Son

Immunohematology, Volume 20 , ISSUE 3, 184–186

Case report | 14-December-2020

Case report and review: alloimmunization, delayed hemolytic transfusion reaction, and clinically significant anti-Yta in a patient with ß-thalassemia/sickle cell anemia

Christopher D. Hillyer, Jacquelynn M. Hall, Karen O. Tiegerman, Eugene M. Berkman

Immunohematology, Volume 7 , ISSUE 4, 102–106

Article | 15-February-2021

An update on the Scianna blood group system

lacking low-prevalence antigens. An important recent report of an acute hemolytic transfusion reaction due to anti-Sc2 provides an excellent example of the potential adverse consequences of categorizing low-prevalence antibodies as “clinically insignificant.”10 In their patient with a previously identified anti-Sc2, electronic or immediate-spin crossmatches were performed rather than compatibility testing using an indirect antiglobulin test because of an assumption that anti-Sc2 was not clinically

P.A.R. Brunker, W.A. Flegel

Immunohematology, Volume 35 , ISSUE 2, 48–50

Review | 29-October-2019

Raph blood group system

cancer progression, the significance in transfusion medicine is limited to one report of a hemolytic transfusion reaction in Subject 5.

Michele Hayes

Immunohematology, Volume 30 , ISSUE 1, 6–10

Review | 01-December-2019

P1PK: The blood group system that changed its name and expanded

is generally a weak and cold-reactive antibody not implicated in hemolytic transfusion reaction (HTR) or hemolytic disease of the fetus and newborn while Pk antibodies can cause HTR, and anti-NOR is regarded as a polyagglutinin. A higher frequency of miscarriage is seen in women with the rare phenotypes p, P1k, and P2k. Furthermore, the Pk and P1 antigens have wide tissue distributions and can act as host receptors for various pathogens and toxins. Why p individuals lack not only Pk and P

Åsa Hellberg, Julia S. Westman, Britt Thuresson, Martin L. Olsson

Immunohematology, Volume 29 , ISSUE 1, 25–33

Article | 17-November-2020

Acute hemolysis due to passively transfused high-titer anti-B causing spontaneous in vitro agglutination

during the exchange consisted first of one unit of group B, D+, AS-1 packed red blood cells (RBCs), resuspended in group AB fresh frozen plasma (FFP), followed by one unit of group O, D-, CPDA-1 RBCs resuspended in group AB FFP. During the second infusion, the infant displayed an increase in temperature and hemoglobinuria, characteristics consistent with an acute intravascular hemolytic transfusion reaction. Clerical errors and hemolysis due to polyagglutinable infant RBCs were ruled out. Further

Gregg Boothe, Mark E. Brecher, Mamie B. Root, Judy Robinson, Nancy R. Haley

Immunohematology, Volume 11 , ISSUE 2, 43–45

Article | 17-November-2020

Analysis ofthe routine use of polyethylene glycol (PEG) as an enhancement medium

This study compared the performance of polyethylene glycol (PEG) and low-ionic saline solutions (LISS) as enhancement media for routine use in a large transfusion service. A PEG additive solution (PEG plus LISS) was compared to a LISS additive (LISS plus polymers) and to an albumin-indirect antiglobulin test (A-IAT). Fifty serum samples containing clinically significant alloantibodies and fifty samples without alloantibodies were tested. Following an acute hemolytic transfusion reaction (HTR

Vicki J. Barrett, James R. Stubbs, Karen Stuardi, Angela Hollis, Leslie Clear

Immunohematology, Volume 11 , ISSUE 1, 11–13

Case report | 21-March-2020

Hyperhemolytic transfusion reaction attributable to anti-Fy3 in a patient with sickle cell disease

Hb decreased to 2.4 g/dL. The LDH level was 1687 U/L, and her reticulocyte count was 2.6%. A delayed hemolytic transfusion reaction with hyperhemolysis secondary to anti-Fy3 was suspected and was successfully treated with IVIG and high-dose prednisone. To the best of our knowledge, this is the first published case of hyperhemolysis in sickle cell disease attributable to anti-Fy3.

Meredith A. Reyes, Orieji C. Illoh

Immunohematology, Volume 24 , ISSUE 2, 45–51

Article | 17-February-2021

Two Thai Burmese descendants with A4GALT*01N.21, p phenotype, and anti-PP1Pk

RBC or pregnancy sensitization. The absence of all three antigens leads to the rare p phenotype and the production of the mixture component antibody, anti-PP1Pk.2,3 This antibody is often associated with hemolytic transfusion reaction (HTR), hemolytic disease of the fetus and newborn (HDFN), and spontaneous abortion in early pregnancy.4 Anti-PP1Pk has been found to be a mixture of IgM and IgG isotypes and able to react over a wide range of temperatures and potentially bind and activate complement

K. Intharanut, W. Sasikarn, W. Chusri, O. Nathalang

Immunohematology, Volume 36 , ISSUE 2, 64–68

Case report | 26-October-2019

Anti-Jk3 in a Filipino man

Shaina McCaskill, Scott Wise, Sheila Tinsley

Immunohematology, Volume 31 , ISSUE 3, 119–122

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