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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Main Authors: Tahsim Anwar, Satya Prakash, Ansuman Sahu, Somnath Mukherjee, Debasish Mishra
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
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.
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institution Kabale University
issn 0973-6247
1998-3565
language English
publishDate 2025-07-01
publisher Wolters Kluwer Medknow Publications
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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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