Haemolysis induced by intravenously‐administered immunoglobulin

Two concurrent cases of haemolysis that was induced by intravenously‐administered γ‐globulin are reported. Haemolysis, predominantly as a result of passively‐acquired anti‐A antibodies, occurred twice in one patient; anti‐D antibodies also were incriminated in the first haemolytic episode. Passively‐acquired anti‐D antibodies that were found in the same batch of γ‐globulin contributed to the haemolytic episode in the second patient. These adverse reactions could have been prevented if a minor crossmatch procedure had been performed before the commencement of intravenous γ‐globulin therapy. It is considered important that manufacturers of intravenously‐administered γ‐globulin preparations decide safe titres of these alloantibodies, and that suitable volumes be dispatched with each batch to enable a minor crossmatch procedure to be performed. (Med J Aust 1989; 150: 404‐406)