Delayed Hemolytic Transfusion Reaction with Alloimmunization of Rh Phenotype: A Two-Case Study / 대한수혈학회지

Delayed hemolytic transfusion reaction is difficult to prevent using an unexpected antibody test performed prior to transfusion, and unlike acute hemolytic transfusion reaction, it occurs a few days after blood transfusion. Hence, determining the reason for delayed hemolytic transfusion reaction may be a tim-consuming task for clinicians Here, we report our experience of two cases of delayed hemolytic transfusion reaction as a result of the unexpected antibody production to Rh blood group antigens after transfusion. The first patient with a history of transfusion during admission was identified as having anti-E and anti-C antibodies according to the antibody identification test at the time of re-admission. The second patient who had chronic blood transfusion due to cancer treatment was found to have anti-C antibody. Both patients received transfusion of Rh antigen-compatible RBC units only after unexpected antibody development. However, like both cases, patients receiving continuous blood transfusion should be considered for a routine Rh phenotype test.

A Case of Delayed Hemolytic Transfusion Reaction Due to Anti-E(rh") / 대한내과학회지

Delayed hemolytic transfusion reaction occurs when the transfused red cells possess an antigen to which the patient has been previously sensitized. Red cells are destructed by an antibody not detected by compatibility testiing some time after the transfusion. Anti-E(rh") is the Rh antibody that found second most commonly after anti-D in Korea, but very seldom causes hemolytic disease. Recently we experienced a case of delayed hemolytic transfusion reaction due to anti-E(rh") in a 37-year-old woman. Three days after the transfusion, she showed a fall in hematocrit and elevation of indirect bilirubin and LDH accompanied by a positive indirect antiglobulin test. Anti-E(rh") was identified in the patient's serum by antibody screening and identification test.