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[Delayed hemolytic transfusion reaction caused by an anti-U]
V Taliano1, M Fleury, R Pichette
1Services transfusionnels, Société Canadienne de la Croix Rouge, Montréal.
Summary
Delayed hemolytic transfusion reactions due to anti-U are rare. This third reported case highlights the importance of recent cross-matches for transfused patients and recruiting U-negative blood donors.
Area of Science:
- Transfusion Medicine
- Immunology
- Hematology
Background:
- Delayed hemolytic transfusion reactions (DHTRs) are uncommon complications of blood transfusions.
- Anti-U alloantibodies are particularly rare, with only two prior cases documented in medical literature.
Observation:
- A multiparous Black woman with severe microcytic anemia presented with a negative direct antiglobulin test and a cold allo-antibody (anti-P1).
- Despite initial successful transfusions, she developed signs of hemolysis and a positive direct antiglobulin test post-transfusion.
- Serological investigation revealed the presence of anti-U alloantibody in the patient's serum and eluate.
Findings:
- The patient, phenotyped as U-negative (Fy(a-b-) M, N, S-s-U-), developed a delayed hemolytic transfusion reaction.
- This reaction occurred after transfusion with U-positive red blood cells, confirming the presence of anti-U.
- Successful management involved transfusion with U-negative red blood cells.
Implications:
- This case underscores the critical need for cross-matching blood samples within 48 hours for patients transfused within the preceding three months.
- It emphasizes the importance of identifying and recruiting U-negative blood donors for rare donor registries to manage such rare alloantibodies.
- The findings contribute to understanding the clinical significance and management of anti-U mediated hemolytic transfusion reactions.