Anaphylactic Transfusion Reaction in a Patient with Anhaptoglobinemia: The First Case in Korea

• Published in: Annals of laboratory medicine Vol. 32; no. 4; pp. 304 - 306
• Main Authors: Kim, Hyunsoo, Choi, Jonghyeon, Park, Kyoung Un, Kim, Hyon-Suk, Min, Yoo Hong, Kim, Moon Jung, Kim, Hyun Ok
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society for Laboratory Medicine 01.07.2012; 대한진단검사의학회
• Subjects: Alleles; Anaphylaxis - etiology; Antineoplastic Agents - therapeutic use; Case Report; Female; Gene Deletion; Haptoglobins - genetics; Haptoglobins - immunology; Humans; Isoantibodies - immunology; Leukemia, Promyelocytic, Acute - complications; Leukemia, Promyelocytic, Acute - diagnosis; Leukemia, Promyelocytic, Acute - drug therapy; Middle Aged; Phenotype; Platelet Transfusion - adverse effects; Recurrence; Republic of Korea; Thrombocytopenia - complications; Thrombocytopenia - diagnosis; 병리학; Republic of Korea; Haptoglobin; Platelet transfusion; Anaphylaxis
• ISSN: 2234-3806; 2234-3814; 2234-3814
• DOI: 10.3343/alm.2012.32.4.304

Anaphylactic transfusion reactions are rare complications of blood transfusions. Anhaptoglobinemia, a condition that has high incidence in Asia, can cause allergic transfusion reactions or anaphylaxis in severe cases. A 50-yr-old Korean woman was diagnosed with relapsed acute promyelocytic leukemia. She developed thrombocytopenia during chemotherapy and an anaphylactic transfusion reaction on the 4th and 5th platelet transfusions immediately after the transfusion of the platelet concentrates was initiated. Blood analysis showed no detectable serum haptoglobin. We examined her genetic phenotype and detected anhaptoglobinemia, which occurs because of an allelic deletion in the Hp gene cluster. The presence of an antibody against haptoglobin was detected by performing ELISA. To prevent anaphylactic reactions, apheresis platelets were transfused after washing. Consequently, anaphylactic transfusion reactions did not develop. Here, we report the first case of anhaptoglobinemia causing anaphylactic transfusion reaction in Korea.