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[Hemolysis can conceal another hemolysis]
P Desnos-Malchiodi1, C Zenner-Zerrouqa, D Bastit
1Service de réanimation chirurgicale et d'anesthésiologie, CHU, I, Rouen, France.
We report a delayed haemolytic reaction during the course of a severe HELLP syndrome, which required red blood cell transfusions. Haemolysis was mainly ascribed to the erythrocyte alloantibody anti-Fy a. The fact that this antibody was undetectable before transfusions (despite cross-matching and anti-erythrocyte antibody screening test) emphasizes the limits of these tests for low antibody concentrations. Moreover, this patient, who had a remarkable obstetrical history, received red blood cell transfusions matched for Rhesus and Kell antigens. The opportunity to perform a more extended phenotype screening for patients at high-risk to develop multiple alloantibodies is discussed.
We report a delayed haemolytic reaction during the course of a severe HELLP syndrome, which required red blood cell transfusions. Haemolysis was mainly ascribed to the erythrocyte alloantibody anti-Fy a. The fact that this antibody was undetectable before transfusions (despite cross-matching and anti-erythrocyte antibody screening test) emphasizes the limits of these tests for low antibody concentrations. Moreover, this patient, who had a remarkable obstetrical history, received red blood cell transfusions matched for Rhesus and Kell antigens. The opportunity to perform a more extended phenotype screening for patients at high-risk to develop multiple alloantibodies is discussed.