A case of hemolytic transfusion reaction due to Lewis b antibody was reported.
The patient, 62-year-old farmer, was suffered from echinococcosis. He has no history to be transfused. His blood types were A, CCDee, Le (a-b-), MNSs, P2, kk, Fy (a+b-), Jk (a+b+), Xg (a+), Di (a-), and he had anti Lea & Leb antibodies.
Right hepatic lobectomy was undergone. Total amount of bleeding in this operation was about 3, 000ml. And during the operation, 1, 600ml of Le (a-b-) blood and 800ml of Le(a-b+) blood was given.
Two days after the operation, hemolytic jaundice and bleeding tendency from DIC appeared. Some part of the lost blood volume was replaced by incompatible Le (a-b+) blood, because Le (a-b-) blood was difficult to obtain due to its low frequency. Moreover few papers reported on hemolytic reaction by anti Leb antibody. Hemolytic reaction and DIC syndrome became even stronger as the days go by.
After the transfusions of Le (a-b-) blood units alone, hemolytic anemia, jaundice and bleeding tendency were improved before long. Anti-Leb antibody titer which elevated initially decreased gradually after stoppage of using Le (b+) blood.
According to these clinical features and laboratory data, we concluded that this hemolytic reaction was occured from Le (b+) incompatible blood transfusion.
