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Updated: Jun 19, 2026
06:29
Methods for Quantitative Detection of Antibody-induced Complement Activation on Red Blood Cells
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.
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.
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