Life-threatening delayed hyperhemolytic transfusion reaction in a patient with sickle cell disease: effective treatment with eculizumab followed by rituximab

被引：40

作者：

Boonyasampant, Mark ^{[1
]}

Weitz, Ilene C. ^{[2
]}

Kay, Brian ^{[1
]}

Boonchalermvichian, Chaiyaporn ^{[2
]}

Liebman, Howard A. ^{[2
]}

Shulman, Ira A. ^{[1
]}

机构：

[1] Los Angeles Cty Univ Southern Calif, Med Ctr, Dept Pathol, Los Angeles, CA USA

[2] Univ So Calif, Keck Sch Med, Dept Med, Jane Anne Nohl Div Hematol, Los Angeles, CA 90033 USA

来源：

TRANSFUSION | 2015年 / 55卷 / 10期

关键词：

COMPLEMENT INHIBITOR ECULIZUMAB; IH;

D O I：

10.1111/trf.13144

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUNDHyperhemolysis in sickle cell disease is a rare and potentially life-threatening complication of transfusion. STUDY DESIGN AND METHODSIn this article we report a case of delayed hemolytic transfusion reaction with resultant hyperhemolysis triggered by an anti-IH autoantibody with alloantibody behavior. RESULTSThe anti-IH was reactive at room temperature as well as 37 degrees C, but only weakly reactive with autologous red blood cells. Initial cold agglutinin titer was 512. The profound, life-threatening, intravascular hemolysis was rapidly and dramatically reduced with the Complement 5 (C5) inhibitory antibody, eculizumab. The auto/allo cold agglutinin was subsequently suppressed with rituximab treatment. CONCLUSIONSEculizumab, a potent C5 inhibitory antibody, can be a rapid and effective therapy for hyperhemolytic transfusion reactions when given in a sufficient dose to fully block the activation of complement C5.

引用

页码：2398 / 2403

页数：6

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