Rheology of Twin Anemia-Polycythemia Sequence: Insights from Hemoglobin Electrophoresis - A Case Report.

IF 1.9 4区医学 Q3 HEMATOLOGY

Transfusion Medicine and Hemotherapy Pub Date : 2026-01-30 DOI:10.1159/000550752

Shane Khan, Todd Ogilby, Hakan Buyukdere, Karen Fung-Kee-Fung

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引用次数: 0

Abstract

Introduction: Twin anemia-polycythemia sequence (TAPS) is a recognized complication of monochorionic (MC) twins due to abnormal placental vasculature. Determining the rheology involved within the abnormal placental vasculature may help in identifying the optimum treatment option.

Case presentation: We describe a case of TAPS which was treated via intrauterine transfusions (IUTs) with partial exchange transfusions in which additional hemoglobin electrophoresis (HbEp) testing was performed on cordocentesis samples taken before and after IUTs and partial exchange transfusions for the donor and recipient twin, respectively. The aim was to assess the flow dynamics from the donor to recipient twin. No differences in hemoglobin A (HbA) were found in the polycythemic twin after 30 min of IUT of the anemic co-twin but within 13 days of first transfusion, greater than a 3-fold rise in HbA was apparent. Within 5 days of second treatment a further 9% rise in HbA was encountered.

Conclusion: The use of HbEp testing in this case provided preliminary insights into the fluid dynamics involved in TAPS; however, further studies are required to achieve better understanding.

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双贫血-红细胞增多症序列的流变学：从血红蛋白电泳的见解-一个病例报告。

简介：双胞胎贫血-红细胞增多症序列（TAPS）是公认的单绒毛膜（MC）双胞胎由于胎盘血管异常的并发症。确定异常胎盘血管内的流变学可能有助于确定最佳治疗方案。病例介绍：我们描述了一例通过宫内输注（IUTs）和部分交换输注治疗的tap病例，其中分别对供体和受体双胞胎在IUTs和部分交换输注前后采集的脐带穿刺样本进行了额外的血红蛋白电泳（HbEp）测试。目的是评估从供体到受体的流动动力学。血红蛋白A （HbA）在多红细胞双胞胎中，在IUT 30分钟后未发现差异，但在第一次输血13天内，HbA明显升高3倍以上。在第二次治疗的5天内，HbA进一步上升了9%。结论：在本病例中使用HbEp检测提供了对TAPS涉及的流体动力学的初步见解；然而，需要进一步的研究来获得更好的理解。

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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来源期刊

Transfusion Medicine and Hemotherapy 医学-免疫学

CiteScore

4.00

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal is devoted to all areas of transfusion medicine. These include the quality and security of blood products, therapy with blood components and plasma derivatives, transfusion-related questions in transplantation, stem cell manipulation, therapeutic and diagnostic problems of homeostasis, immuno-hematological investigations, and legal aspects of the production of blood products as well as hemotherapy. Both comprehensive reviews and primary publications that detail the newest work in transfusion medicine and hemotherapy promote the international exchange of knowledge within these disciplines. Consistent with this goal, continuing clinical education is also specifically addressed.