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Hemoglobin Catabolism Following a Hemolytic Transfusion Reaction in a Patient with Sickle Cell Anemia
Author(s) -
Duvall C. P.,
Alter H. J.,
Rath C. E.
Publication year - 1974
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.1974.tb04549.x
Subject(s) - haptoglobin , hemoglobinuria , hemoglobin , hemolysis , medicine , hemolytic anemia , bilirubin , anemia , immunology , gastroenterology , red cell , sickle cell anemia , disease
A hemolytic transfusion reaction occurring in a patient with sickle cell anemia provided insight into the handling of massive amounts of hemoglobin in patients who lack haptoglobin. Despite the acute intravascular release of 33 gms of hemoglobin, the peak plasma hemochromogen was only 134 mg/100 ml and only 6 per cent of the hemoglobin load was recovered in the urine. In contrast, the serum bilirubin rose sharply to a peak of 30 mg/100 ml within three hours of hemolysis. The minimal hemoglobinuria, the relatively low peak level of plasma hemoglobin, and the marked and rapid elevation of serum bilirubin suggest an increased hemoglobin clearing capacity of the chronically stimulated reticuloendothelial system in patients with chronic severe hemolytic disease.