Hyperhemolysis syndrome in a patient with sickle cell anemia: case report

Clinical presentations and outcomes of COVID‐19 infection in sickle cell disease patients: Case series from Komfo Anokye teaching hospital, Ghana

“…Patient 1 had been hemotransfused multiple times during her pregnancy. Despite transfusion of 7 units of packed cells at HIIU, her hemoglobin level failed to rise leading to suspicion of HS; a potentially fatal phenomenon seen in SCD patients with a past history of numerous transfusions (including use of compatible blood) as in this case 27 . The exact mechanism for this syndrome is unknown but it is postulated to be primarily due to bystander hemolysis where there is destruction of both the recipient's red blood cells (RBCs) and the transfused RBCs by the recipient's antibodies (alloantibodies) in the absence of the expression of red blood cell antigens against which the antibodies are targeted 27 .…”

“…Despite transfusion of 7 units of packed cells at HIIU, her hemoglobin level failed to rise leading to suspicion of HS; a potentially fatal phenomenon seen in SCD patients with a past history of numerous transfusions (including use of compatible blood) as in this case 27 . The exact mechanism for this syndrome is unknown but it is postulated to be primarily due to bystander hemolysis where there is destruction of both the recipient's red blood cells (RBCs) and the transfused RBCs by the recipient's antibodies (alloantibodies) in the absence of the expression of red blood cell antigens against which the antibodies are targeted 27 . HS is a diagnosis of exclusion although laboratory tests can aid in the diagnosis including the direct antiglobulin test (usually negative in the acute stage), lactate dehydrogenase (elevated) and reticulocyte count (usually reticulocytopenia) 27,28 .…”

“…The exact mechanism for this syndrome is unknown but it is postulated to be primarily due to bystander hemolysis where there is destruction of both the recipient's red blood cells (RBCs) and the transfused RBCs by the recipient's antibodies (alloantibodies) in the absence of the expression of red blood cell antigens against which the antibodies are targeted 27 . HS is a diagnosis of exclusion although laboratory tests can aid in the diagnosis including the direct antiglobulin test (usually negative in the acute stage), lactate dehydrogenase (elevated) and reticulocyte count (usually reticulocytopenia) 27,28 . These tests could not be done for our patient due to resource constraints.…”

Recurrent Hyperhemolysis Syndrome in Sickle Cell Disease

“…HS is an uncommon but severe complication following transfusions of pRBCs, which is found especially in patients with SCD. Risk is increased in patients with a history of multiple transfusions [ 13 ]. The rate of incidence of HS in SCD patients is estimated to range from 1% to 19% [ 8 ].…”

Hyperhemolysis Syndrome Following Red Cell Exchange in a Newly Diagnosed Sickle Cell Disease Patient With Spinal Cord Infarction

“…This is meant to reduce exacerbations and the prolongation of HS episodes. In the event of an emergency need to transfuse, there can still be complications even when ABO-matched, Rh-matched, and K-matched units of blood are transfused that are crossmatch-compatible [4][5][6][9][10][11][12][13]. Aside from stopping transfusion, intravenous immunoglobin (IVIG) and corticosteroids, administered together or individually, are associated with the most consistent success [3,4,9].…”