Hyperhemolysis Syndrome without Underlying Hematologic Disease

被引:15
作者
Eberly, Lauren Anne [1 ]
Osman, Diaa [1 ]
Collins, Nathaniel Perryman [1 ]
机构
[1] Univ New Mexico, Hlth Sci Ctr, Dept Internal Med, Albuquerque, NM 87131 USA
关键词
D O I
10.1155/2015/180526
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction. Hyperhemolysis is characterized by a life-threatening hemolytic transfusion reaction, with hemoglobin (Hb) and hematocrit (Hct) dropping markedly lower than before transfusion. This phenomenon, commonly described in sickle cell disease, is a rare occurrence in patients without hemoglobinopathies. Case Report. A 55-year-old male presented to the hospital after a motorcycle crash and received 10 units of cross-matched blood for active bleeding. The patient was blood group O, with a negative antibody screen. Ten days later, he represented complaining of dyspnea and was found to have a hematocrit of 12%. The direct antiglobulin test was positive for anti-immunoglobin G and complement. Indirect antiglobulin test was positive for anti-Jka alloantibodies. Thepresence of Jka antigen was revealed in one unit of previously transfused blood; patient's RBCs were negative for the Jka antigen. Laboratory data demonstrated findings consistent with DHTR, as well as reticulopenia and elevated ferritin levels. He continued to show signs of active hemolysis, requiring a total of 4 subsequent units of pRBCs. Each transfusion precipitated a drop in Hb and Hct to levels lower than before transfusion; once transfusions were held, the patient slowly recovered. Discussion. Hyperhemolysis in the setting of a DHTR can occur in patients without hematologic disease.
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相关论文
共 21 条
[1]   Hyperhemolysis in Sickle Cell Disease [J].
Aragona, Elena ;
Kelly, Michael J. .
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, 2014, 36 (01) :E54-E56
[2]   Hyperhaemolysis syndrome treated with corticosteroids and darbopoietin in a patient with mantle cell lymphoma [J].
Babb, A. ;
Diamantos, N. ;
Sekhar, M. .
TRANSFUSION MEDICINE, 2012, 22 (02) :142-144
[3]   A life-threatening episode of treatment-resistant haemolysis in a pregnant patient with dyserythropoietic anaemia (CDA) type I [J].
Bank, I. ;
Ermens, A. A. M. ;
van der Linden, J. M. ;
Brand, A. .
TRANSFUSION MEDICINE, 2012, 22 (02) :145-147
[4]   POSTTRANSFUSION HYPERHAEMOLYSIS IN A PATIENT WITH SICKLE-CELL DISEASE - USE OF STEROIDS AND INTRAVENOUS IMMUNOGLOBULIN TO PREVENT FURTHER RED-CELL DESTRUCTION [J].
CULLIS, JO ;
WIN, N ;
DUDLEY, JM ;
KAYE, T .
VOX SANGUINIS, 1995, 69 (04) :355-357
[5]   Hyperhemolysis syndrome in anemia of chronic disease [J].
Darabi, K ;
Dzik, S .
TRANSFUSION, 2005, 45 (12) :1930-1933
[6]   Severe reactions associated with transfusion of patients with sickle cell disease [J].
Garratty, G .
TRANSFUSION, 1997, 37 (04) :357-361
[7]  
Garratty G., 1996, AUTOIMMUNE DISORDERS, P79
[8]   Refractory hyperhaemolysis in a patient with β-thalassaemia major [J].
Grainger, JD ;
Makar, Y ;
McManus, A ;
Wynn, R .
TRANSFUSION MEDICINE, 2001, 11 (01) :55-57
[9]   Delayed hemolytic transfusion reactions in sickle cell disease: Simultaneous destruction of recipients' red cells [J].
King, KE ;
Shirey, RS ;
Lankiewicz, MW ;
YoungRamsaran, J ;
Ness, PM .
TRANSFUSION, 1997, 37 (04) :376-381
[10]   Hyperhaemolysis in a beta thalassaemia patient related to an association of red cell allo- and autoantibodies [J].
Mizon, P ;
Cossement, C ;
Mannessier, L ;
Caulier, MT ;
Rose, C ;
Goudemand, J .
TRANSFUSION CLINIQUE ET BIOLOGIQUE, 1996, 3 (04) :257-261