A CASE OF DELAYED HEMOLYTIC TRANSFUSION REACTION DUE TO ANTI-C+e ANTIBODY CAUSED BY PRIMARY IMMUNE RESPONSE
A CASE OF DELAYED HEMOLYTIC TRANSFUSION REACTION DUE TO ANTI-C+e ANTIBODY CAUSED BY PRIMARY IMMUNE RESPONSE
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初次免疫反应抗C e抗体引起迟发型溶血性输血反应一例
DOI：
10.3925/jjtc1958.51.594
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
T. Mikami
中科院分区：
文献类型：
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作者：
J. Kitazawa;M. Inomata;C. Kamata;K. Tanaka;K. Hosokawa;Hirobumi Saito;Tomonori Murakami;M. Ikuta;A. Takemura;S. Hasegawa;T. Mikami
我们在此报告一罕见的迟发性溶血性输血反应（DHTR）可能是由原发性免疫反应引起的。患者是一名69岁的日本女性，因蛛网膜下腔出血接受神经外科手术。为了治疗术后出血，她每天接受2个单位的浓缩红细胞（Ir-RC-MAP），持续6天，共计12个单位。首次输血后第33天，患者出现血红蛋白尿、贫血、血小板减少、血清LDH和总胆红素水平升高以及血清结合珠蛋白水平降低的症状。她的血型是A型，ccDEE。在Rh血型检查中观察到C和e的部分凝血，但在首次输血后第37天消失。在第一次输血后37天收集的患者血清的不规则抗体筛查中，通过MTS-Pap检测IgM型抗C +e。我们发现在临床过程中，抗C +e的免疫球蛋白类别从IgM转变为IgG。这些结果表明，DHTR可能是由于抗C +e引起的原发性免疫反应。
We report here a rare case of delayed hemolytic transfusion reaction (DHTR) probably caused by a primary immune response. The patient was a 69-year-old Japanese female who underwent neurosurgery for subarachnoid hemorrhage. For treatment of post-operative hemorrhage, she received 2 units of packed red cells (Ir-RC-MAP) per day for 6 days, for a total of 12 units. On day 33 after the first transfusion, she showed symptoms of hemoglobinuria, anemia, thrombocytopenia, elevated levels of serum LDH and total bilirubin, and a decreased level of serum haptoglobin. Her blood was typed as A, ccDEE. Partial coagulation was observed on Rh blood-type examination for C and e but disappeared on day 37 after the first transfusion. On irregular antibody screening of patient serum collected 37 days after the first transfusion, IgM type anti-C+e was detected by MTS-Pap. We found that the immunoglobulin class of anti-C+e switched from IgM to IgG during the clinical course. These findings suggest that the DHTR was probably due to anti-C+e caused by a primary immune response.