A CASE OF DELAYED HEMOLYTIC TRANSFUSION REACTION DUE TO ANTI-C+e ANTIBODY CAUSED BY PRIMARY IMMUNE RESPONSE

• Published in: Journal of the Japan Society of Blood Transfusion Vol. 51; no. 6; pp. 594 - 600
• Main Authors: Tanaka, Kazuto, Ikuta, Mitsuru, Mikami, Takafumi, Hosokawa, Kazuko, Inomata, Makiko, Hasegawa, Seiko, Saito, Hirobumi, Murakami, Tomonori, Takemura, Atsuhito, Kitazawa, Junichi, Kamata, Chiduru
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 2005
• Subjects: anti-C+e antibody; anti-HLA antibody; delayed hemolytic transfusion reaction; post-transfusion thrombocytopenia; primary immune response
• ISSN: 0546-1448; 1883-8383; 1883-8383
• DOI: 10.3925/jjtc1958.51.594

We report here a rare case of delayed hemolytic transfusion reaction (DHTR) probably caused by a primary immune response. The patient was a 69-year-old Japanese female who underwent neurosurgery for subarachnoid hemorrhage. For treatment of post-operative hemorrhage, she received 2 units of packed red cells (Ir-RC-MAP) per day for 6 days, for a total of 12 units. On day 33 after the first transfusion, she showed symptoms of hemoglobinuria, anemia, thrombocytopenia, elevated levels of serum LDH and total bilirubin, and a decreased level of serum haptoglobin. Her blood was typed as A, ccDEE. Partial coagulation was observed on Rh blood-type examination for C and e but disappeared on day 37 after the first transfusion. On irregular antibody screening of patient serum collected 37 days after the first transfusion, IgM type anti-C+e was detected by MTS-Pap. We found that the immunoglobulin class of anti-C+e switched from IgM to IgG during the clinical course. These findings suggest that the DHTR was probably due to anti-C+e caused by a primary immune response.