Haemolysis induced by intravenously-administered immunoglobulin

Two concurrent cases of haemolysis that was induced by intravenously-administered gamma-globulin are reported. Haemolysis, predominantly as a result of passively-acquired anti-A antibodies, occurred twice in one patient; anti-D antibodies also were incriminated in the first haemolytic episode. Passively-acquired anti-D antibodies that were found in the same batch of gamma-globulin contributed to the haemolytic episode in the second patient. These adverse reactions could have been prevented if a minor crossmatch procedure had been performed before the commencement of intravenous gamma-globulin therapy. It is considered important that manufacturers of intravenously-administered gamma-globulin preparations decide safe titres of these alloantibodies, and that suitable volumes be dispatched with each batch to enable a minor crossmatch procedure to be performed.