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An acute haemolytic transfusion reaction caused by anti‐Wr a
Author(s) -
Cherian G,
Search S,
Thomas E,
Poole J,
Davies S. V,
Massey E
Publication year - 2007
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.2007.00739.x
Subject(s) - medicine , haemolytic disease , bilirubin , blood transfusion , antibody , transfusion reaction , antigen , gastroenterology , immunology , pediatrics , biology , pregnancy , fetus , genetics
summary The Wright (Wr a ) antigen is found on the red blood cells of approximately 1 : 1000 Caucasians. Anti‐Wr a has been reported to be present in 1 : 25 to 1 : 100 healthy blood donors and an even higher proportion of hospital patients. Incompatibility due to anti‐Wr a might therefore be expected to occur in approximately 1 in 50 000 blood transfusions. Reports of haemolytic transfusion reactions (HTR) and haemolytic disease of the newborn due to anti‐Wr a are, however, rare. We report an acute HTR due to anti‐Wr a in a 58‐year‐old man with myelodysplastic syndrome associated with rigors, shortness of breath and a significant rise in serum bilirubin from 16 μmol L −1 pretransfusion to 110 μmol L −1 immediately afterwards. This was accompanied by the appearance of bilirubin and urobilinogen in his urine and a fall in haemoglobin of nearly 2 g dL −1 following the transfusion. Anti‐Wr a was the only antibody implicated. When tested against the recipients plasma, Wr(a+) panel cells and the transfused unit responsible for the reaction were 2–3+ by indirect antiglobulin test (IAT) and the donation typed as Wr(a+). The recipient had the common Wr(a−) phenotype. The reaction resulted in the patient being admitted to hospital for 2 days. The increasing use of electronic issue may result in more frequent reports of reactions due to anti‐Wr a using current screening cells.