A YOUNG FEMALE BRAZILIAN WITH SICKLE CELL DISEASE WHO HAD DIFFICULTY OBTAINING COMATIBLE BLOOD FOR TRANSFUSION DUE TO MULTIPLE ALLOANTIBODIES (UNEXPECTED ANTIBODIES) AGAINST ERYTHROCYTES

• Maruyama Mitsuko

  Blood Transfusion Service, Mie University Hospital

• Tanaka Yumi

  Blood Transfusion Service, Mie University Hospital

• Nakagawa Yasuhisa

  Central Clinical Laboratory, Mie University Hospital

• Fujii Shinobu

  Central Clinical Laboratory, Mie University Hospital

• Moriguchi Yoko

  Central Clinical Laboratory, Mie University Hospital

• Kassai Chieko

  Blood Transfusion Service, Mie University Hospital

• Shinoda Noriyuki

  Central Clinical Laboratory, Mie University Hospital

• Fujieda Atsushi

  Department of Hematology and Oncology, Mie University Graduate School of Medicine

• Wada Hideo

  Department of Laboratory Medicine, Mie University Graduate School of Medicine

• Nobori Tsutomu

  Department of Laboratory Medicine, Mie University Graduate School of Medicine

• Imai Shigemi

  Mie Red Cross Blood Center

• Uchikawa Makoto

  Tokyo Metropolitan Red Cross Blood Center

• Masuya Masahiro

  Blood Transfusion Service, Mie University Hospital

Bibliographic Information

Other Title

• 複数の不規則抗体により適合血確保に難渋した鎌状赤血球症の１例

Abstract

We describe an 18-year-old female Brazilian with sickle cell disease (SCD) who had a difficulty in obtaining compatible blood for transfusion because of the presence of multiple alloantibodies (unexpected antibodies) against erythrocytes. A diagnosis of SCD had been made when she was 2 years old and since then had repeated blood transfusions while in Brazil. Four days before visiting Japan, she was treated with intravenous fluid and blood transfusion due to acute alcoholic poisoning. On the day after arriving in Japan, she was admitted to our hospital because of bilateral femoral pain. Severe hemolysis was determined and blood transfusion was required. Anti-E, -M and -S alloantibodies were identified by irregular antibody screening. Although we performed compatibility testing using E, M and S antigen-negative concentrated red blood cells (CRC), only a few units of crossmatch-compatible blood were found. A blood sample from this patient was sent to the Tokyo Metropolitan Red Cross Blood Center reference lab to examine the patient's extended red blood cell (RBC) phenotype and to confirm the presence of additional alloantibodies. The patient's reticulocytes and RBCs were isolated by Percoll-Urografin density gradient centrifugation and washing with hypotonic (0.3%) saline, respectively. Her RBC phenotype was determined as O, D +, C+, c+, E-, e+, M-, N+, S-, s+, Jk (a+b+), Fy (a+b+), Pl+, Le (a-b-), Di (a-b+). Further, IgG anti-Yk^a alloantibody was also detected in her serum. We were able to obtain extended phenotype-matched CRC to provide blood compatible with her existing antibodies from the nationwide blood supply. We recommend both extended phenotype-matching and white blood cell reduction for transfusions to SCD patients to prevent the production of alloantibodies.

Journal

• Japanese Journal of Transfusion and Cell Therapy

  Japanese Journal of Transfusion and Cell Therapy 52 (4), 501-506, 2006

  The Japan Society of Transfusion Medicine and Cell Therapy

Keywords

• sickle cell disease
• multiple alloantibodies (unexpected antibodies)
• extended phenotype-matching
• anti-Yk^a alloantibody

Details

• CRID: 1390282680249699968
• NII Article ID: 130003707142
• NII Article ID: 10018786015
• NII Book ID: AA12159645
• DOI: 10.3925/jjtc.52.501
• ISSN: 18830625
• ISSN: 18813011
• Web Site: https://search.jamas.or.jp/link/ui/2007040392
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed