Acute hemolytic transfusion reaction caused by anti-M antibodies: a case report and literature review.

Laboratory medicine Pub Date : 2024-11-04 DOI:10.1093/labmed/lmae038

Yanjing He, Yang Li, Qiushi Wang

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Abstract

Objective: We report a rare case of acute hemolytic reactions caused by immunoglobulin (Ig)M anti-M antibody and present a literature review.

Case report: A 61-year-old male patient who underwent blood transfusion developed fever, chills, soy sauce-colored urine, and changes in laboratory test results, including persistently decreased hemoglobin levels, neutrophilia, elevated lactate dehydrogenase level, acute kidney injury, mild acute liver injury, and activation of the coagulation system, indicating acute hemolytic transfusion reaction (AHTR). Antibody screening and major crossmatching results indicated weak positive at 37°C for both posttransfusion and pretransfusion sample. Subsequent serological examinations indicated the presence of IgM anti-M antibodies in plasma but the direct antiglobulin and elution tests were negative. Antibody hemolytic activity assay confirmed AHTR caused by anti-M. The transfused red blood cells were MM and the patient is NN. These signs and symptoms disappeared rapidly and required no additional interventions before discharge.

Conclusion: The accurate diagnosis of anti-M antibody-mediated acute hemolysis is essential for guiding treatment decisions.

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抗 M 抗体引起的急性溶血性输血反应：病例报告和文献综述。

摘要我们报告了一例罕见的由免疫球蛋白（Ig）M 抗 M 抗体引起的急性溶血反应，并进行了文献综述：一名 61 岁的男性患者在接受输血后出现发热、寒战、酱油色尿液，实验室检查结果发生变化，包括血红蛋白水平持续下降、中性粒细胞增多、乳酸脱氢酶水平升高、急性肾损伤、轻度急性肝损伤和凝血系统活化，提示急性溶血性输血反应（AHTR）。抗体筛查和主要交叉配血结果显示，输血后和输血前样本在 37°C 时均呈弱阳性。随后的血清学检查显示血浆中存在 IgM 抗 M 抗体，但直接抗球蛋白和洗脱试验均为阴性。抗体溶血活性检测证实，AHTR 是由抗-M 引起的。输注的红细胞为 MM，患者为 NN。这些症状和体征迅速消失，出院前无需进行其他干预：结论：抗 M 抗体介导的急性溶血的准确诊断对于指导治疗决策至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Laboratory medicine

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