Severe hemolytic transfusion reaction due to anti-D in a D+ patient with sickle cell disease.

TitleSevere hemolytic transfusion reaction due to anti-D in a D+ patient with sickle cell disease.
Publication TypeJournal Article
Year of Publication2015
AuthorsIpe TS, Wilkes JJ, Hartung HD, Westhoff CM, Chou ST, Friedman DF
JournalJ Pediatr Hematol Oncol
Volume37
Issue2
Paginatione135-7
Date Published03/2015
ISSN1536-3678
KeywordsAnemia, Sickle Cell, Blood Group Incompatibility, Child, Preschool, Erythrocyte Transfusion, Humans, Isoantibodies, Male, Pain, Prognosis, Rh-Hr Blood-Group System, Transfusion Reaction
Abstract

A 5-year-old male with sickle cell disease presented with pain, dark urine, and fatigue 10 days after a red blood cell (RBC) transfusion. Laboratory evaluation demonstrated severe anemia, blood type O+, and anti-D in the serum. Anti-D in a D+ patient led to RH genotyping, which revealed homozygosity for RHD*DAU4 that encodes partial D antigen. Anti-D in this patient whose RBCs exclusively express partial D caused a delayed hemolytic transfusion reaction after exposure to D+ RBCs. The finding of anti-D in a D+patient should be investigated by molecular methods to help distinguish an alloantibody from an autoantibody.

DOI10.1097/MPH.0000000000000241
Alternate JournalJ. Pediatr. Hematol. Oncol.
PubMed ID25171447
PubMed Central IDPMC4333075
Grant List5T32HD064567 / HD / NICHD NIH HHS / United States
T32 HD064567 / HD / NICHD NIH HHS / United States