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Transient coagulation abnormalities after incompatible blood transfusion
Critical Care Medicine
|January 1, 1975
Summary
An unusual hemolytic transfusion reaction occurred when group O blood received group A red cells. This led to rapid drops in blood cells and clotting factors, suggesting kinin system activation, not typical intravascular coagulation.
Area of Science:
- Transfusion Medicine
- Hematology
- Immunology
Background:
- Hemolytic transfusion reactions (HTRs) can cause severe hematological abnormalities.
- Plasmapheresis procedures carry a risk of ABO-incompatible red blood cell exposure.
- Rapid, transient consumption of blood cells and coagulation factors is a rare HTR presentation.
Purpose of the Study:
- To report an unusual case of a hemolytic transfusion reaction.
- To investigate the rapid, transient hematological changes following an ABO-incompatible transfusion.
- To explore the underlying pathophysiological mechanism of the observed reaction.
Main Methods:
- Case report of a patient experiencing an ABO-incompatible red blood cell transfusion.
- Monitoring of cellular elements (granulocytes, platelets) and coagulation factors (fibrinogen, V, VIII, IX) post-transfusion.
- Analysis of the temporal dynamics of hematological recovery.
Main Results:
- Immediate development of granulocytopenia, thrombocytopenia, and hypofibrinogenemia.
- Significant decrease in coagulation factors V, VIII, and IX post-transfusion.
- Complete normalization of cellular elements and coagulation proteins within one hour.
Conclusions:
- The rapid recovery suggests a mechanism other than de novo synthesis following consumption.
- Kinin system activation is postulated as the primary cause of the observed hematological changes.
- This case highlights a distinct pathophysiological pathway in ABO-incompatible HTRs.