日本輸血学会雑誌
Online ISSN : 1883-8383
Print ISSN : 0546-1448
一次免疫応答より惹起されたと考えられる遅発性溶血性輸血副作用の1症例
石丸 健天満 智佳藤原 義一大江 真司加藤 俊明池田 久實
著者情報
ジャーナル フリー

2004 年 50 巻 6 号 p. 768-773

詳細
抄録

We report here a rare case of delayed hemolytic transfusion reaction (DHTR) probably caused by a primary immune response. The patient was a 32-year-old Japanese female who underwent surgery for ectopic pregnancy. For treatment of intraoperative hemorrhage shock, she received 5 units of RBCs (all positive for Jka, C and e antigen) that were crossmatch-compatible by indirect antiglobulin testing using polyethylene glycol (PEG-IAT). On day 22 after transfusion, she showed symptoms of hemoglobinuria, reticulocytosis, and elevated serum levels of LDH (1, 106IU/L) and total-bilirubin (5.6mg/dL). She did not receive further transfusion during this period. On irregular antibody screening of patient serum collected 24 days after transfusion, anti-Jka was detected by PEG-IAT. Her blood was typed as B, DccEE, Jk (a-b+). She then received 1 unit of RBCs (Jka-negative but C, e-positive). Her anemia improved after transfusion and no hemolytic transfusion reaction was observed. IgM type anti-C+e in the patient detected on day 24 after the first transfusion did not seem to be involved in the DHTR because transfusion of C+e+RBCs on the 24th day did not cause DHTR. Further, we demonstrated that the immunoglobulin (Ig) class of the anti-Jka switched from IgM to IgG during the clinical course. These results suggest that the DHTR was probably due to anti-Jka caused by a primary immune response.

著者関連情報
© 日本輸血・細胞治療学会
前の記事 次の記事
feedback
Top