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Adverse Occurrence type:
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
A 44-year-old woman was admitted for vascular surgery. At the time of her second admission anti-E antibodies were detected and she received 560 ml of E-antigen-negative RBCs. After this transfusion, DAT was negative, total bilirubin and LDH were elevated, and haptoglobin was reduced. No clinical symptoms were observed. A DHTR was diagnosed from these data. Anti-E, -Jka, -Dia, -Fyb and -S antibodies were detected in a postransfusion sample obtained 11 days after the transfusion. The ABO and Rh phenotypes of transfused units were compatible with those of patient's RBCs, but other phenotypes of transfused units were unknown.
Demonstration of imputability or root cause:
The patient had only serologic hemolysis without evidence of clinical hemolysis.
Suggest new keywords:
ANTI-E, Jk(a), Di(a), Fy(b), anti-S
Yamane K, Yagihashi A, Sasaki M, Kuwashima K, Morio A and Watanabe N. (1998). A delayed hemolytic transfusion reaction (DHTR) with multiple alloantibodies (Anti-E, Jka, Dia, Fyb, and S) induced by E-antigen-negative, crossmatch-compatible blood. Immunopharmacology and immunotoxicology 20:531-9.
Due to the fact that is not possible to know from these case what were the antibodies involved in the DHTR because the phenotype of the transfused units was unknown I am not sure abote the utility of include it. Rejected??? We will change it to a DSTR since antibodies were detected.
Expert comments for publication:
It is not possible to know from this case what were the antibodies involved in the DHTR because the phenotype of the transfused units was unknown.