Acute Hemolytic Transfusion Reaction (AHTR), anti-B antibodies in platelets, probiotic associated

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
In general, the incidence of passively mediated hemolytic transfusion reactions associated with platelet transfusions are: 1:1000-1:25,000 for all platelet transfusions and 1:100-1:9000 for minor-mismatched platelet transfusions. The incidence of higher titer anti-B antibody formation after taking probiotics was not determined.
Time to detection: 
15 minutes
Alerting signals, symptoms, evidence of occurrence: 
Severe back and flank pain associated with hypertension and chest pain. A posttransfusion specimen was noted to be grossly hemolyzed and the urine specimen was dark brown. Hemoglobin decreased 2-4 g/dL. Bilirubin increased and peaked at 7-9 hours post-transfusion.
Demonstration of imputability or root cause: 
Serologic evaluatoin and blocking antibody titers with suspension of probiotic pills and evaluation of previous transfusion recipients' clinical course.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
passively mediated hemolytic transfusion reaction
Suggest references: 
Daniel-Johnson, J., Leitman, S., Klein, H., Alter, H., Lee-Stroka, A., Scheinberg, P., Pantin, J. and Quillen, K. (2009). Probiotic-associated high-titer anti-B in a group A platelet donor as a cause of severe hemolytic transfusion reactions. Transfsuion 49(9):1845-1849.
Expert comments for publication: 
Interesting case reports.