Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series
Alloimmunization is a significant complication of blood transfusion, especially in sickle cell patients, and may lead to a delayed hemolytic transfusion reaction (DHTR). DHTR is defined as evident hemolysis and a positive direct antiglobulin test (DAT) 24 h to 28 days posttransfusion with either a p...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Asian Journal of Transfusion Science |
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| Online Access: | https://journals.lww.com/10.4103/ajts.ajts_191_23 |
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| author | Tahsim Anwar Satya Prakash Ansuman Sahu Somnath Mukherjee Debasish Mishra |
| author_facet | Tahsim Anwar Satya Prakash Ansuman Sahu Somnath Mukherjee Debasish Mishra |
| author_sort | Tahsim Anwar |
| collection | DOAJ |
| description | Alloimmunization is a significant complication of blood transfusion, especially in sickle cell patients, and may lead to a delayed hemolytic transfusion reaction (DHTR). DHTR is defined as evident hemolysis and a positive direct antiglobulin test (DAT) 24 h to 28 days posttransfusion with either a positive eluate or a newly identified alloantibody in the plasma. Hyperhemolysis syndrome (HS) is a fatal form of DHTR in which the posttransfusion hemoglobin (Hb) level is less than the pretransfusion Hb level. In this case series, we have reported three cases of alloimmunized sickle cell disease patients with clinically significant DHTR. The second case is typical of HS. All three cases were DAT positive, alloimmunized with multiple alloantibodies, and had substantial hemolysis posttransfusion. In this series, we have provided an algorithmic approach to resolve such complex immunohematological problems and have highlighted some of the limitations of serology methods. High-dose corticosteroid and intravenous immunoglobulin prove to be an effective treatment for DHTR. |
| format | Article |
| id | doaj-art-d3d43136380a473b97df7a85610cd4ff |
| institution | Kabale University |
| issn | 0973-6247 1998-3565 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Asian Journal of Transfusion Science |
| spelling | doaj-art-d3d43136380a473b97df7a85610cd4ff2025-08-20T03:39:15ZengWolters Kluwer Medknow PublicationsAsian Journal of Transfusion Science0973-62471998-35652025-07-0119116717210.4103/ajts.ajts_191_23Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case seriesTahsim AnwarSatya PrakashAnsuman SahuSomnath MukherjeeDebasish MishraAlloimmunization is a significant complication of blood transfusion, especially in sickle cell patients, and may lead to a delayed hemolytic transfusion reaction (DHTR). DHTR is defined as evident hemolysis and a positive direct antiglobulin test (DAT) 24 h to 28 days posttransfusion with either a positive eluate or a newly identified alloantibody in the plasma. Hyperhemolysis syndrome (HS) is a fatal form of DHTR in which the posttransfusion hemoglobin (Hb) level is less than the pretransfusion Hb level. In this case series, we have reported three cases of alloimmunized sickle cell disease patients with clinically significant DHTR. The second case is typical of HS. All three cases were DAT positive, alloimmunized with multiple alloantibodies, and had substantial hemolysis posttransfusion. In this series, we have provided an algorithmic approach to resolve such complex immunohematological problems and have highlighted some of the limitations of serology methods. High-dose corticosteroid and intravenous immunoglobulin prove to be an effective treatment for DHTR.https://journals.lww.com/10.4103/ajts.ajts_191_23alloimmunizationdelayed hemolytic transfusion reactiondirect antiglobulin testhyperhemolysis syndromesickle cell disease |
| spellingShingle | Tahsim Anwar Satya Prakash Ansuman Sahu Somnath Mukherjee Debasish Mishra Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series Asian Journal of Transfusion Science alloimmunization delayed hemolytic transfusion reaction direct antiglobulin test hyperhemolysis syndrome sickle cell disease |
| title | Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series |
| title_full | Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series |
| title_fullStr | Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series |
| title_full_unstemmed | Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series |
| title_short | Alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients: A case series |
| title_sort | alloimmunization and consequential delayed hemolytic transfusion reactions in sickle cell disease patients a case series |
| topic | alloimmunization delayed hemolytic transfusion reaction direct antiglobulin test hyperhemolysis syndrome sickle cell disease |
| url | https://journals.lww.com/10.4103/ajts.ajts_191_23 |
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