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Early alloimmunization in an infant to red cell antigens-Rare but possible in the 'right' circumstances
Anwen Maddock1, Sue Warrington1, Amanda Lyver2
1New Zealand Blood Service, Christchurch, New Zealand.
Insights
Red blood cell alloimmunization is rare in young infants. This case study details a neonate with haemophagocytic lymphohistiocytosis (HLH) who developed antibodies to E and K antigens after transfusion.
Area of Science:
- Neonatal Medicine
- Immunology
- Transfusion Medicine
Background:
- Red blood cell (RBC) alloimmunization is infrequently documented in infants under 4-6 months.
- Haemophagocytic lymphohistiocytosis (HLH) is a critical condition characterized by an overactive immune system.
Background:
Red blood cell (RBC) alloimmunization is rarely reported in infants less than 4-6 months of age.
Methods/Materials:
Blood group and antibody screening used the gel card technique. All blood products were leukoreduced. All RBC doses transfused were group O, E-neg, K-neg but the pooled platelets transfused on day 45 and 61 included donors who were K-pos, and that transfused on day 61 also included an E-pos donor.
Results:
We report a group O neonate with haemophagocytic lymphohistiocytosis (HLH) who developed alloantibodies to E and K antigens at 65 days (9 weeks) of age.
Conclusion:
HLH is an inflammatory, 'hyperimmune' state, and alloimmunization is more likely when inflammation is present. If significant inflammation is present, transfusions should be avoided if possible.
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