Delayed Hemolytic Transfusion Reaction in a Sickle Cell Disease Patient: A Case Report.

Area of Science:

• Hematology
• Transfusion Medicine
• Sickle Cell Disease Research

Background:

• Alloimmunization is a known complication in patients with sickle cell disease (SCD).
• Delayed hemolytic transfusion reactions (DHTR) are a significant consequence of alloimmunization in SCD.
• DHTR presents diagnostic and management challenges for healthcare providers treating SCD patients.

Observation:

• A case report details a 33-year-old African female with hemoglobin SS (Hb SS) SCD and a history of transfusions.
• The patient presented with vaso-occlusive crisis (VOC) symptoms triggered by sepsis from E. coli pyelonephritis.
• She received packed red blood cells (PRBC) for worsening anemia and VOC, subsequently developing a DHTR.

Findings:

• The patient experienced a delayed hemolytic transfusion reaction (DHTR) following PRBC transfusion.
• DHTR exacerbated her anemia and vaso-occlusive crisis (VOC).
• Symptoms of DHTR were initially mistaken for a worsening pain crisis.

Implications:

• DHTR requires careful consideration in SCD patients presenting with worsening anemia or VOC symptoms.
• Early recognition and management of DHTR are crucial to prevent severe complications like hyper-hemolytic crisis.
• This case highlights the importance of vigilance for transfusion reactions in transfused SCD populations.