Clara Ibanez1, Anoosha Habibi2,3,4, Armand Mekontso-Dessap5, Philippe Chadebech1,2,4, Btissam Chami1, Philippe Bierling1,2, Frédéric Galactéros2,3,4, Claire Rieux6, Joëlle Nataf7, Pablo Bartolucci2,3,4, Thierry Peyrard4,7,8, France Pirenne1,2,4. 1. Établissement Français du Sang, Ile de France, Hôpital Henri Mondor. 2. IMRB, INSERM U955, Equipe 2: Transfusion et maladies du globule rouge, Institut Mondor de Recherche Biomédicale, UPEC, Créteil, France. 3. Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri Mondor, AP-HP, UPEC, Créteil. 4. Laboratoire D'Excellence GR-Ex, F-75015 Paris, France. 5. Service de Réanimation Médicale, Hôpital Henri Mondor, AP-HP, UPEC. 6. Unité de Sécurité Transfusionnelle et d'Hémovigilance, Hôpital Henri Mondor, AP-HP, Créteil, France. 7. Institut National de la Transfusion Sanguine, Département Centre National de référence pour les Groupes Sanguins. 8. INSERM UMR_S1134, F-75015 Paris, France.
Abstract
BACKGROUND: Delayed hemolytic transfusion reaction (DHTR) is a life-threatening condition in sickle cell disease (SCD) patients that is frequently complicated by hyperhemolysis. Antibodies resulting from antigen disparity between donors of European ancestry and patients of African ancestry are common, but situations involving antibodies not classically of clinical significance are also encountered. Anti-HI is generally considered to be an innocuous naturally occurring antibody. STUDY DESIGN AND METHODS: We describe two cases of hyperhemolysis with anti-HI and provide details of the reported cases. RESULTS: Both SCD patients were polyimmunized and belonged to blood group B. They developed anti-HI that was reactive at 37°C, after the transfusion of group O red blood cell units matched for all known and produced antibodies classically considered to be clinically significant. Both patients developed DHTR with hyperhemolysis. In the first case, a pregnant woman, a second transfusion was unavoidable and the patient died from cardiac arrest. The state of the second patient improved without the need for further transfusion. CONCLUSION: Three other cases of DHTR with anti-HI have been described in the literature in SCD patients. The two additional cases reported here definitively demonstrate that anti-HI is dangerous in SCD patients. As a result, ABO-identical matching (including A1 status) must be considered in SCD patients with anti-HI.
BACKGROUND: Delayed hemolytic transfusion reaction (DHTR) is a life-threatening condition in sickle cell disease (SCD) patients that is frequently complicated by hyperhemolysis. Antibodies resulting from antigen disparity between donors of European ancestry and patients of African ancestry are common, but situations involving antibodies not classically of clinical significance are also encountered. Anti-HI is generally considered to be an innocuous naturally occurring antibody. STUDY DESIGN AND METHODS: We describe two cases of hyperhemolysis with anti-HI and provide details of the reported cases. RESULTS: Both SCDpatients were polyimmunized and belonged to blood group B. They developed anti-HI that was reactive at 37°C, after the transfusion of group O red blood cell units matched for all known and produced antibodies classically considered to be clinically significant. Both patients developed DHTR with hyperhemolysis. In the first case, a pregnant woman, a second transfusion was unavoidable and the patient died from cardiac arrest. The state of the second patient improved without the need for further transfusion. CONCLUSION: Three other cases of DHTR with anti-HI have been described in the literature in SCDpatients. The two additional cases reported here definitively demonstrate that anti-HI is dangerous in SCDpatients. As a result, ABO-identical matching (including A1 status) must be considered in SCDpatients with anti-HI.
Authors: Connie M Arthur; Satheesh Chonat; Ross Fasano; Marianne E M Yee; Cassandra D Josephson; John D Roback; Sean R Stowell Journal: Transfus Med Rev Date: 2019-10-18
Authors: Swee Lay Thein; France Pirenne; Ross M Fasano; Anoosha Habibi; Pablo Bartolucci; Satheesh Chonat; Jeanne E Hendrickson; Sean R Stowell Journal: Haematologica Date: 2020-02-06 Impact factor: 11.047