A CASE OF DELAYED HEMOLYTIC TRANSFUSION REACTION DUE TO ANTI-C+e ANTIBODY CAUSED BY PRIMARY IMMUNE RESPONSE

Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion Pub Date : 2005-01-01 DOI:10.3925/JJTC1958.51.594

J. Kitazawa, M. Inomata, C. Kamata, K. Tanaka, K. Hosokawa, Hirobumi Saito, Tomonori Murakami, M. Ikuta, A. Takemura, S. Hasegawa, T. Mikami

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引用次数: 7

Abstract

We report here a rare case of delayed hemolytic transfusion reaction (DHTR) probably caused by a primary immune response. The patient was a 69-year-old Japanese female who underwent neurosurgery for subarachnoid hemorrhage. For treatment of post-operative hemorrhage, she received 2 units of packed red cells (Ir-RC-MAP) per day for 6 days, for a total of 12 units. On day 33 after the first transfusion, she showed symptoms of hemoglobinuria, anemia, thrombocytopenia, elevated levels of serum LDH and total bilirubin, and a decreased level of serum haptoglobin. Her blood was typed as A, ccDEE. Partial coagulation was observed on Rh blood-type examination for C and e but disappeared on day 37 after the first transfusion. On irregular antibody screening of patient serum collected 37 days after the first transfusion, IgM type anti-C+e was detected by MTS-Pap. We found that the immunoglobulin class of anti-C+e switched from IgM to IgG during the clinical course. These findings suggest that the DHTR was probably due to anti-C+e caused by a primary immune response.

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原发性免疫反应引起的抗c +e抗体延迟溶血性输血反应1例

我们在此报告一例罕见的迟发性溶血性输血反应(DHTR)，可能是由原发性免疫反应引起的。患者为69岁日本女性，因蛛网膜下腔出血接受神经外科手术。治疗术后出血，每天给予2个单位的红细胞(Ir-RC-MAP)，连续6天，共计12个单位。第一次输血后第33天，患者出现血红蛋白尿、贫血、血小板减少、血清LDH、总胆红素升高、血清触珠蛋白降低等症状。她的血型是A型，ccDEE型。Rh型血C、e检查出现部分凝血，第一次输血后第37天部分凝血消失。对首次输血后37天采集的患者血清进行不规则抗体筛查，采用MTS-Pap检测IgM型抗c +e。我们发现，在临床过程中，抗c +e的免疫球蛋白类别从IgM转换为IgG。这些结果表明，DHTR可能是由原发性免疫反应引起的抗c +e引起的。

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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Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion

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