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, P
2, kk, Fy (a+b-), Jk (a+b+), Xg (a+), Di (a-), and he had anti Le
a & Le
b 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 Le
b 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-Le
b 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.
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