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Related Experiment Video

Updated: Jun 19, 2026

Methods for Quantitative Detection of Antibody-induced Complement Activation on Red Blood Cells

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Published on: January 29, 2014

Autoantibody formation after alloimmunization inducing bystander immune hemolysis.

M Mota¹, C Bley, M G Aravechia

¹Departamento de Hemoterapia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Immunohematology

|October 28, 2009

Summary

Allogeneic blood transfusions can trigger red blood cell (RBC) autoantibodies, leading to immune hemolysis. Prompt treatment with IVIG and corticosteroids successfully managed this complication in a patient, avoiding further transfusions.

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Area of Science:

Immunology
Transfusion Medicine

Background:

Allogeneic blood transfusions are essential for treating anemia but can lead to alloimmunization and autoimmune complications.
Developing red blood cell (RBC) autoantibodies post-transfusion is a rare but serious complication.

Observation:

A 72-year-old woman developed RBC autoantibodies and immune hemolysis after receiving RBC transfusions for severe anemia.
The patient presented with a drop in hemoglobin, positive direct antiglobulin test, and identification of alloanti-c and autoantibody anti-Jk(b).

Findings:

Transfusion of ABO- and D-compatible RBCs, despite a negative initial antibody screen, triggered alloimmunization and autoantibody formation.
The patient experienced temporary bystander immune hemolysis, characterized by joint pain, fever, hemoglobinuria, and a significant drop in hemoglobin levels.

Implications:

This case highlights the potential for RBC transfusions to induce autoantibodies and subsequent hemolysis.
Effective management with intravenous immunoglobulin (IVIG), corticosteroids, and rituximab can resolve the complication and prevent further transfusions.