Acute hemolytic transfusion reaction caused by anti-Co^a

Abstract

Co a is a high-frequency blood group antigen in the Colton blood group system expressed on red blood cells (RBCs) of approximately 99.8 percent of random persons. Anti-Co a has been reported to cause delayed hemolytic transfusion reactions, hemolytic disease of the newborn, and accelerated clearance of RBCs in vivo. Acute hemolytic transfusion reactions (AHTRs) have not previously been reported. A 58-year-old man was hospitalized for vascular surgery. Initial blood bank evaluation revealed anti-Fy a . The patient received six units of RBCs during his initial hospitalization and developed anti-E. A subsequent sample was sent to the reference laboratory when all units of RBCs appeared incompatible. Additional studies, including alloadsorptions, revealed the presence of anti-E, anti-Fy a , and an apparent warm autoantibody. One unit of least-incompatible RBCs was transfused during surgery. The patient had an increase in temperature. Hemoglobinuria and a decrease in hematocrit were also noted. Due to the clinical impression of an AHTR, the pre-and postreaction samples were reevaluated in the reference laboratory and demonstrated the presence of anti-Co a in both. Based on clinical and laboratory evaluation this patient appears to have had an AHTR due to anti-Co a . This is the first known reported case of an AHTR caused by anti-Co a .

Anti Colton-A Foeto-Neonatal Haemolytic Disesase: Diagnosis; Clinical Outcome and Family Study

“…Few reports of significant delayed or acute transfusion reactions or haemolytic disease of the foetus and newborn attributable to anti-Co a have been reported, although both are known to occur with severe morbidity; anti-Co b is relatively rare and often found in patient's sera containing other alloantibodies. In vivo studies have shown that anti-Co a and anti-Co b antibodies are able to reduce the survival of targeted erythrocytes [19][20][21][22][23]. There are also reports of auto-antibodies mimicking Colton specificities [24,25].…”

Potential Role of Antibodies against Aquaporin-1 in Patients with Central Nervous System Demyelination

“…Τhe pathophysiological relevance of reduced AQP1 presence in WM tissue from patients with NMOSD phenotype remains to be proven. As described in Section 2.3, AQP1 contains the Colton blood group antigen expressed on erythrocytes [51], while antibodies against Colton antigens can cause hemolytic diseases [52]. Therefore, it has been argued that if AQP1-Abs existed in NMOSD, they might also cause hemolytic disease, which is absent in NMOSD [56].…”

“…AQP1 contains the Colton blood group antigen expressed on erythrocytes [ 51 ]. Antibodies against Colton antigens are very rare and can cause transfusion reactions or hemolytic disease [ 52 ]. Interestingly, in Section 3.2 we describe a case with high titer of AQP1 antibodies and the development of both autoimmune hemolytic anemia (AIHA) and a clinical relapse in a patient with NMOSD phenotype; recovery of both diseases occurred with a simultaneous dramatic drop of AQP1-Abs.…”