Two Cases of Severe Hemolytic Transfusion Reactions Caused by Anti-Jkb Antibody / 대한수혈학회지

ABSTRACT

We report two patients who suffered from hemolytic transfusion reactions due to anti-Jkb antibody one showed acute- and the other showed delayed-type hemolysis. The first patient was a 40-year-old man who suffered from epilepsy after the operation for arteriovenous malformation 16 years ago. He received five units of red blood cells (RBC) after right temporal lobectomy. On the fifteenth postoperative day, fever and chill developed during transfusion of one unit of packed RBC, followed by dark urine and oliguria. The polyethylene glycol-Coombs test and enzyme test revealed anti-Jkb antibody which had not been detected on the pretransfusion specimen. The second patient was a 41-year-old man who was admitted for the reoperation of the prosthetic mitral valve. Because hemoglobin was 5.9g/dL at admission, he received five units of packed RBCs. Oliguria and laboratory findings consistent with hemolytic anemia were observed from the third day of transfusion. Anti-Jkb antibody was detected on antiglobulin phase. Both patients developed acute renal failure (ARF) and hemodialysis with conservative management were done. They finally recovered from ARF without any residual complications. Implementation of more sensitive pretransfusion tests should be considered to prevent rare, but serious hemolytic transfusion reactions.