Abstract
In polyagglutination, erythrocytes agglutinate with almost all samples of normal serum bue to erythrocyte expression of cryptic antigens caused by infectious disease or blood disease. There are many types and reasons for polyagglutination.
We report a fatal case of polyagglutination related to adult T-cell leukemia and Pseudomonas aeruginosa infection. A 53-year-old female patient had received a bone marrow transplantation from an unrelated donor as well as chemotherapy. She was admitted to our hospital because of back pain caused by lumber compression fracture. Eleven days later, she suddenly experienced cardiopulmonary arrest. She was resuscitated and admitted to intensive care unit. P. aeruginosa was detected by blood culture. In spite of intensive care, she died 9 days after admission. We observed non-specific agglutination in a minor cross-match test after P. aeruginosa infection. The patient's erythrocytes did not agglutinate with her own serum, but agglutinated with almost all serum samples of the same blood type. On analysis of the patient's blood sample at the Hiroshima Red Cross Blood Center, Tk polyagglutination was strongly suspected. We therefore conducted an additional test using a strain of P. aeruginosa cultured in the patient's blood sample. This strain was cultured and reacted with normal blood type O erythrocytes at 37°C. These erythrocytes reacted to blood type AB serum and agglutification was identified after 4 days. These results indicate that the agglutination was caused by the direct effect of erythrocytes of blood type O reacting with P. aeruginosa.
