Delayed Hemolytic Transfusion Reaction/Hyperhemolysis Syndrome in Children With Sickle Cell Disease

Talano, Julie; Hillery, Cheryl A.; Gottschall, Jerome L.; Baylerian, Diane M.; Scott, J. Paul

doi:10.1542/peds.111.6.e661

Cited by 186 publications

(208 citation statements)

References 14 publications

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“…Further transfusions are avoided as best as possible. Similar observations were documented by Talano J-AM and colleagues in their report of hyperhaemolysis in SCD children [3].…”

Section: Discussionsupporting

confidence: 87%

“…SCD usually requires red blood cell transfusions to manage complications including anaemia, acute chest syndrome, stroke and splenic sequestration. Alloimmunization is a serious complication after exposure to donor or foreign red cells and incidence is reported as high as 5 to 36 % in SCD patients [3,4]. Clinical manifestations of delayed haemolytic transfusion reactions (DHTR) can be different from those described in other patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fatal Delayed Haemolytic Transfusion Reaction and Hyperhaemolysis Syndrome in a Pregnant Woman with Sickle Cell Anaemia

Asnawi

Sathar

Mohamed

et al. 2015

Indian J Hematol Blood Transfus

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Clinical manifestations of sickle cell disease (SCD) arise from the tendency of the sickle haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape. Sickle cell crisis is a devastating complication that may occur in patients with SCD. If not managed properly permanent organ damage and even death may be the final outcome. A case of a 32-year-old Nigerian lady, Gravida 1 Para 0 in her first trimester, with SCD who developed signs and symptoms of delayed haemolytic transfusion reaction after receiving packed red cell transfusion is demonstrated. Multiple red cell alloantibodies were detected in the patient's plasma; anti-Fy a, anti-Jk b and anti-E. The patient miscarriaged and succumbed to complications of hyperhaemolysis with delayed haemolytic transfusion reaction, acute chest syndrome and renal failure. There is an urgent need for mandatory red cell antibody screen and identification especially in high-risk cases. Prevention of alloimmunization by supplying phenotype-specific red cells is also required.

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“…Further transfusions are avoided as best as possible. Similar observations were documented by Talano J-AM and colleagues in their report of hyperhaemolysis in SCD children [3].…”

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Fatal Delayed Haemolytic Transfusion Reaction and Hyperhaemolysis Syndrome in a Pregnant Woman with Sickle Cell Anaemia

Asnawi

Sathar

Mohamed

et al. 2015

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

show abstract

“…[5][6][7][8][9] DHTR has been reported to occur in 4-11% of SCD patients given blood transfusions. 6,[10][11][12] DHTRs occur from a few days to two weeks after a blood transfusion and manifest as clinical features of acute hemolysis (hemoglobinuria, jaundice, and pallor) combined with symptoms suggesting severe vaso-occlusive crisis (pain, fever, and sometimes acute chest syndrome). The destruction of both the donor's and the recipient's RBCs leads to an abrupt drop in the hemoglobin level, to a value lower than the pre-transfusion value.…”

Section: Introductionmentioning

confidence: 99%

“…Corticosteroid and/or intravenous immunoglobulin (IVIg) therapy has been reported to ensure recovery from DHTR. [5][6][7][8][9]13,14 More recently, two studies reported the use of rituximab for preventing DHTR. 13,15 The pathophysiology of this syndrome remains unclear, especially when there is no detectable antibody.…”

Section: Introductionmentioning

confidence: 99%

Delayed hemolytic transfusion reaction in children with sickle cell disease

Montalembert¹,

Dumont²,

Heilbronner³

et al. 2011

Haematologica

106

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“…Delayed hemolytic transfusion reactions usually occur between one and four weeks post-transfusion (Beers et al, 2006) and represent approximately 11% of all complications of RBC transfusions (Talano et al, 2003). The mechanism is due to alloantibodies formed against One-third of delayed hemolytic transfusion reactions (DHTR) are mediated by the Kidd antibody.…”

Section: Discussionmentioning

confidence: 99%

History and Hemolysis: Not an Easy Kidd’s Game and Review of Literature

Nguyen¹,

Wu²,

Gai³

et al. 2016

EJBM

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Seven days later, she returned to the emergency department (ED) with complaints of progressive back pain and dark urine for two days. Previous history of dark urine was denied. Significant findings included a temperature of 101 o F, scleral icterus, and pale frenulum. Vaginal bleeding was noted but hepatosplenomegaly or costovertebral angle tenderness were not elicited. Laboratory results are shown in Table 1. Peripheral smear showed slight microcytosis with moderate hypochromia and hemoglobinuria was inconclusive because numerous RBCs were found on urinary analysis. Computed tomography (CT) scanning of abdomen and pelvis showed no evidence of occult bleed. The initial working diagnosis in the emergency room was hemolytic uremic syndrome (HUS) and two units of PRBC were requested given her symptomatic anemia. Q: What is the triad of HUS?A: Hemolytic anemia, thrombocytopenia, and acute renal failure.However, before the PRBC was given, further discussions with the patient revealed a recent transfusion history, raising the suspicion of an alloantibody etiology. A DAT was ordered, which was negative (Table 1). Continued suspicion prompted an eluate study resulting in detection of anti-E, anti-K, and a new anti-Jk b antibody. Phenotyping of two units of PRBC transfused seven days prior were all positive for Jk b antigen, confirming that anti-Jk b was the etiology of her hemolysis. Subsequently, two units of PRBCs negative for antigens Jk b , E, and K were given. The acute renal failure and the markers of hemolysis improved with supportive care, and she received a transfusion card prior to leaving the hospital. DISCUSSIONDelayed hemolytic transfusion reactions usually occur between one and four weeks post-transfusion (Beers et al., 2006) and represent approximately 11% of all complications of RBC transfusions (Talano et al., 2003). The mechanism is due to alloantibodies formed against One-third of delayed hemolytic transfusion reactions (DHTR) are mediated by the Kidd antibody. We report a case of Kidd-induced DHTR, detailing the diagnostic dilemma in a patient presenting with nonspecific symptoms and inconclusive data. The importance of a full history, including a transfusion history, is emphasized to overcome the dilemma and concludes with a literature review of Kidd (type anti-Jk b ) antibodies.

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Delayed Hemolytic Transfusion Reaction/Hyperhemolysis Syndrome in Children With Sickle Cell Disease

Cited by 186 publications

References 14 publications

Fatal Delayed Haemolytic Transfusion Reaction and Hyperhaemolysis Syndrome in a Pregnant Woman with Sickle Cell Anaemia

Fatal Delayed Haemolytic Transfusion Reaction and Hyperhaemolysis Syndrome in a Pregnant Woman with Sickle Cell Anaemia

Delayed hemolytic transfusion reaction in children with sickle cell disease

History and Hemolysis: Not an Easy Kidd’s Game and Review of Literature

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