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Delayed hemolytic transfusion reactions in sickle cell anemia
Southern Medical Journal
|August 1, 1989
Summary
Delayed hemolytic transfusion reactions (DHTR) can occur in sickle cell anemia patients after transfusions. These reactions may cause severe pain crises and require careful consideration in post-transfusion patient management.
Area of Science:
- Hematology
- Transfusion Medicine
- Immunology
Background:
- Sickle cell anemia (SCA) patients often require blood transfusions.
- Delayed hemolytic transfusion reactions (DHTR) are a known complication.
- The incidence and clinical presentation of DHTR in SCA require further elucidation.
Observation:
- Three SCA patients developed DHTR over 18 months at Cook Country Hospital.
- DHTR presented with severe pain crisis, spherocytic hemolytic anemia, and positive direct antiglobulin test.
- Previously undetected erythrocyte alloantibodies and Hb A disappearance were noted.
Findings:
- DHTR in SCA patients is associated with severe pain crises.
- Diagnostic markers include spherocytic hemolytic anemia and positive direct antiglobulin test.
- Erythrocyte alloantibodies and Hb A changes are key indicators of DHTR.
Implications:
- DHTR may be more frequent than commonly recognized in SCA.
- Consider DHTR in SCA patients experiencing pain crises post-transfusion.
- Early recognition and management of DHTR are crucial for SCA patient outcomes.