Acute blood transfusion reaction in a tertiary care hospital in Southern Punjab, Pakistan

Background: Blood transfusion is a lifesaving process but carries many risks. Majority of these had been reduced with better diagnostic and management strategies. But the risk of non-infectious adverse transfusion reactions though reduced but cannot be eliminated. Hemovigilance is the system to monitor such reactions.Methods: The objective of current study was to know the frequency of adverse transfusion reactions and to compare it with local and international data. Retrospective cross-sectional descriptive study was done in Ibn-e- Sina hospital. Adverse transfusion reactions reported to blood bank was analysed according to hospital protocol.Results: Out of 6050 blood transfusions 23 (0.38%) develop adverse transfusion reactions. Febrile nonhemolytic transfusion reaction was the commonest adverse event and whole blood was the component implicated.Conclusions: Adverse transfusion reactions are non-infectious complications of blood transfusion which in spite of all efforts cannot be avoided. Frequency of adverse transfusion reactions in our study was 0.38% and Febrile nonhemolytic transfusion reaction was commonest reported reaction type. Hemovigilance system is necessary to monitor, investigate and control such activities.

Clinico-laboratory findings in male lupus patients from a tertiary care hospital, Pakistan

This study was conducted to delineate the clinical pattern of a cohort of Pakistani male patients with systemic lupus erythematosus [SLE]. Clinical and laboratory data were collected of 24 male patients who were diagnosed with SLE and admitted to a tertiary care hospital between 1986 and 2001. Imaging and invasive studies [including aspirations and biopsies] were also recorded. Fourteen patients [58%] had renal involvement, with WHO class 4 and 5 comprising 89% of the cases. Eight patients [33%] had neurological involvement. Out of these 8 patients, 3 presented with psychosis [12.5%] and 4 [17%] with seizures. Twenty three patients [96%] had hematological involvement, 6 [25%] had serosal and 10 [41%] had articular involvement. Cutaneous lesions were noted in 10 [41%] patients. A majority of the patients were noncompliant and were lost to follow-up; therefore, ultimate outcome could not be clearly delineated. A high index of suspicion for SLE in males may permit early diagnosis and dictate the need for more aggressive therapy

Systemic lupus eryhematosus presenting as Hemolytic uremic syndrome: a case Report

Associating systemic lupus erythematosus [SLE], with an initial presentation of hemolytic uremic syndrome [HUS] is rare. We report a case of 21-year old Afghani female admitted to our hospital with an initial complaint of high grade fever and diffuse maculopapular rash and swelling of lower limbs. Diagnosis of atypical HUS was established according to the clinical triad of HUS without a veriotoxin-producing organism in her stool and the pathological finding compatible to thrombotic microangiopathy. In addition, her symptoms fulfilled the 1982 revised criteria for the classification of SLE. After pulse methylprednisolone, cyclophosphamide and plasmapheresis therapies, her laboratory findings and general condition improved. Unfortunately she was lost to follow up as she decided to return back to Afghanistan