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Delayed hemolytic transfusion reaction caused by anti‐P 1 antibody
Author(s) -
Chandeysson P.L.,
Flye M.W.,
Simpkins S.M.,
Holland P.V.
Publication year - 1981
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1981.21181127489.x
Subject(s) - medicine , antibody , hemoglobinuria , oliguria , immunology , blood transfusion , hemolysis , transfusion reaction , rh blood group system , gastroenterology , renal function
A 67‐year‐old white woman received transfusions of a total of 87 units of whole blood and red blood cells during and within 48 hours following a pneumonectomy. Although she had previously received blood transfusions, unexpected antibodies were not detectable by routine screening. On the second postoperative day, she developed fever, hemoglobinemia, hemoglobinuria, and oliguria. However, the direct antiglobulin test and the antibody screen were negative. On the eighth postoperative day, an IgM anti‐P 1 antibody was detected for the first time. This anti‐P 1 antibody increased in thermal amplitude from 22 to 37 C, but remained IgM. The circulating transfused P 1 ‐positive cells decreased progressively without evidence of bleeding. Testing of the patient's preoperative blood at 15 C found her serum to be weakly reactive with P 1 cells, while her own cells were PM 2 . Thus, an anamnestic response to the P 1 antigen is the most likely cause of her delayed hemolytic transfusion reaction.