ABSTRACT
Pretransfusion testing is very important to prevent transfusion of incompatible red cells, which might result in a hemolytic transfusion reaction. This includes the detection of antibodies in recipients' serum and compatibility testing between donor cells and recipient serum. The most commonly used methods include gel and tube techniques. We present a case in which an anti-E alloantibody was detected by gel method but not by tube testing. As a result, red cells that were retrospectively phenotyped as positive for E antigen were inadvertently selected and transfused after crossmatch using the same tube method. After transfusion, the patient developed signs of hemolytic transfusion reaction. This case highlights the potential risk of transfusion of incompatible red cells when alloantibody detection is solely relied on tube testing.
Subject(s)
Blood Grouping and Crossmatching , Transfusion Reaction , Blood Banks , Female , Humans , Isoantibodies/immunology , Middle Aged , Multiple Myeloma , Plasma Exchange , Pulmonary Embolism/therapy , Transfusion Reaction/diagnosis , Transfusion Reaction/etiology , Transfusion Reaction/therapyABSTRACT
Warm autoimmune hemolytic anemia (WAIHA), the most common of the relatively uncommon autoimmune-mediated hemolytic anemias (AIHAs), is mediated by polyclonal immunoglobulin (Ig)G autoantibodies in most cases. Herein, we present a case of WAIHA involving a direct antiglobulin test (DAT) with an initially negative result. Using a modified DAT protocol, repeat testing of the same specimen material from a previously healthy 53-year-old man yielded positive results. This case demonstrates that investigation of an apparently negative DAT result plays a critical role in the differential diagnosis of patients with rapidly progressing hemolytic anemia and the reversal of that decline.
