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KMID : 0387720090200020144
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Korean Journal of Blood Transfusion
2009 Volume.20 No. 2 p.144 ~ p.150
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A Case of Delayed Hemolytic Transfusion Reaction in a Patient with Anti-c, Anti-E, and Anti-Jkb
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Kim Se-Rim
Hur Mi-Na
Lee Kyu-Man
Chun Wook
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Abstract
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Delayed hemolytic transfusion reaction (DHTR) due to multiple red blood cell (RBC) alloantibodies has rarely been reported in Korea. We report a case of DHTR in a patient with anti-c, anti-E, and anti-Jkb. A 45-year-old man visited the emergency room with flame burn injury over 61% of his entire body. He received six units of packed RBCs and three units of fresh frozen plasma during the operation for excision and glycerol-preserved allografting. His hemoglobin (Hb) level gradually decreased from 13.5 g/dL on the operation day to 7.8 g/dL on the 11th postoperative day in spite of receiving three and two additional units of packed RBCs on the 8th and 9th postoperative days, respectively. His laboratory data was total bilirubin/direct bilirubin 15.9/11.4 mg/dL, lactate dehydrogenase 983 IU/L, haptoglobin 5.93 mg/dL and plasma hemoglobin 8.0 mg/dL. The urinalysis revealed hemoglobinuria, and the peripheral blood film showed moderate spherocytosis. Both the direct and indirect antiglobulin tests were positive, and the follow-up antibody identification test showed anti-c, anti-E, and Jkb. His Hb levels increased after he was transfused with two units of packed RBCs without c, E, and Jkb antigens. This is a case of DHTR due to alloimmunization, which developed within a short interval after the patient had received multiple transfusions.
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KEYWORD
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Delayed hemolytic transfusion reaction, Multiple alloantibodies, Anti-c, Anti-E, Anti-Jkb
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