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Case of Acute Hemolytic Transfusion Reaction due to Anti-Fya Alloantibody in a Patient with Autoimmune Hemolytic Anemia
자가면역용혈환자에서 항-Fya 동종항체에 의한 급성용혈성수혈반응 1예
Korean J Blood Transfus 2018;29:320−327
Published online December 31, 2018;  https://doi.org/10.17945/kjbt.2018.29.3.320
© 2018 The Korean Society of Blood Transfusion.

Seung Jun Choi1, Hyunjin Nah2, Yundeok Kim3, Sinyoung Kim1, Hyun Ok Kim1
최승준1ㆍ나현진2ㆍ김윤덕3ㆍ김신영1ㆍ김현옥1

Department of Laboratory Medicine, Yonsei University College of Medicine1, Seoul, Department of Laboratory Medicine, Serim Hospital2, Incheon, Department of Internal Medicine, Yonsei University College of Medicine3, Seoul, Korea
연세대학교 의과대학 진단검사의학교실1, 세림병원 진단검사의학과2, 연세대학교 의과대학 내과학교실3
Hyun Ok Kim
Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: 82-2-2228-2444, Fax: 82-2-364-1583, E-mail: hyunok1019@yuhs.ac, ORCID: http://orcid.org/0000-0002-4964-1963
Received August 3, 2018; Revised September 12, 2018; Accepted September 15, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
A 72-year-old man with general weakness visited the outpatient clinic of the hematology department. The patient had been treated under the diagnosis of autoimmune hemolytic anemia for 2 years. His hemoglobin level at the time of the visit was 6.3 g/dL, and a blood transfusion was requested to treat his anemia. The patient’s blood type was A, RhD positive. Antibody screening and identification test showed agglutination in all reagent cells with a positive reaction to autologous red blood cells (RBCs). He had a prior transfusion history with three least incompatible RBCs. The patient returned home after receiving one unit of leukoreduced filtered RBC, which was the least incompatible blood in the crossmatching test. After approximately five hours, however, fever, chills, dyspnea, abdominal pain, and hematuria appeared and the patient returned to the emergency room next day after the transfusion. The anti-Fya antibody, which was masked by the autoantibody, was identified after autoadsorption using polyethylene glycol. He was diagnosed with an acute hemolytic transfusion reaction due to anti-Fya that had not been detected before the transfusion. In this setting, it is necessary to consider the identification of coexisting alloantibodies in patients with autoantibodies and to become more familiar with the method of autoantibody adsorption.
Keywords : Acute hemolytic transfusion reaction, Autoantibody, Alloantibody, Panagglutination, Duffy blood group

 

December 2018, 29 (3)
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