A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management
A delayed hemolytic transfusion reaction (DHTR) is a potential complication for patients with sickle cell disease (SCD) who develop red blood cell (RBC) alloimmunization to foreign antigens from allogeneic transfusions, potentially resulting in life-threatening hemolytic anemia between 24 hours and...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2024/9980747 |
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| author | Cassandra P. Wang Denise Malicki Courtney D. Thornburg Sonya Martinez Jennifer C. Yu |
| author_facet | Cassandra P. Wang Denise Malicki Courtney D. Thornburg Sonya Martinez Jennifer C. Yu |
| author_sort | Cassandra P. Wang |
| collection | DOAJ |
| description | A delayed hemolytic transfusion reaction (DHTR) is a potential complication for patients with sickle cell disease (SCD) who develop red blood cell (RBC) alloimmunization to foreign antigens from allogeneic transfusions, potentially resulting in life-threatening hemolytic anemia between 24 hours and 28 days after the transfusion. Guidelines have suggested obtaining an extended RBC antigen profile by genotyping in patients with SCD to provide increased accuracy for antigen matching. We present a pediatric patient with SCD and a rare RBC phenotype that was not identified by serology who developed DHTR after her second lifetime transfusion and highlight the potential advantages of molecular genotyping. She was successfully managed by transfusion with “least incompatible” packed RBCs and aggressive medical management per American Society of Hematology clinical guidelines. Molecular genotyping is advantageous over serologic phenotyping because it can provide additional antigen information, such as increased accuracy for C antigen determination and Fyb antigen matching. Having RBC genotyping results on file for patients with SCD can facilitate care in two ways—by preventing alloimmunization with potential hemolytic transfusion reaction and by responding rapidly to request rare donors when complicating antibodies arise. |
| format | Article |
| id | doaj-art-33f2af1bd5d24fc8bd30f85143f711b2 |
| institution | Kabale University |
| issn | 2090-6579 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-33f2af1bd5d24fc8bd30f85143f711b22025-08-20T03:55:15ZengWileyCase Reports in Hematology2090-65792024-01-01202410.1155/2024/9980747A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and ManagementCassandra P. Wang0Denise Malicki1Courtney D. Thornburg2Sonya Martinez3Jennifer C. Yu4Department of PediatricsDepartment of Pathology and Laboratory MedicineDepartment of PediatricsDepartment of Pathology and Laboratory MedicineDepartment of PediatricsA delayed hemolytic transfusion reaction (DHTR) is a potential complication for patients with sickle cell disease (SCD) who develop red blood cell (RBC) alloimmunization to foreign antigens from allogeneic transfusions, potentially resulting in life-threatening hemolytic anemia between 24 hours and 28 days after the transfusion. Guidelines have suggested obtaining an extended RBC antigen profile by genotyping in patients with SCD to provide increased accuracy for antigen matching. We present a pediatric patient with SCD and a rare RBC phenotype that was not identified by serology who developed DHTR after her second lifetime transfusion and highlight the potential advantages of molecular genotyping. She was successfully managed by transfusion with “least incompatible” packed RBCs and aggressive medical management per American Society of Hematology clinical guidelines. Molecular genotyping is advantageous over serologic phenotyping because it can provide additional antigen information, such as increased accuracy for C antigen determination and Fyb antigen matching. Having RBC genotyping results on file for patients with SCD can facilitate care in two ways—by preventing alloimmunization with potential hemolytic transfusion reaction and by responding rapidly to request rare donors when complicating antibodies arise.http://dx.doi.org/10.1155/2024/9980747 |
| spellingShingle | Cassandra P. Wang Denise Malicki Courtney D. Thornburg Sonya Martinez Jennifer C. Yu A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management Case Reports in Hematology |
| title | A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management |
| title_full | A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management |
| title_fullStr | A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management |
| title_full_unstemmed | A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management |
| title_short | A Case Report of Red Blood Cell Alloimmunization and Delayed Hemolytic Transfusion Reaction in a Patient with an Uncommon Phenotype in Sickle Cell Disease: Review of Diagnosis and Management |
| title_sort | case report of red blood cell alloimmunization and delayed hemolytic transfusion reaction in a patient with an uncommon phenotype in sickle cell disease review of diagnosis and management |
| url | http://dx.doi.org/10.1155/2024/9980747 |
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