Life-threatening delayed hyperhemolytic transfusion reaction in a patient with sickle cell disease: effective treatment with eculizumab followed by rituximab
Life-threatening delayed hyperhemolytic transfusion reaction in a patient with sickle cell disease: effective treatment with eculizumab followed by rituximab
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DOI：
10.1111/trf.13144
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发表时间：
2015-10-01
期刊：
影响因子：
2.9
通讯作者：
Shulman, Ira A.
中科院分区：
文献类型：
--
作者：
Boonyasampant, Mark;Weitz, Ilene C.;Shulman, Ira A.
研究设计和方法在这篇文章中，我们报告了一例迟发性溶血性输血反应与由此产生的高溶血引发的抗IH自身抗体与同种抗体的行为。初始冷凝集素滴度为512。使用补体5（C5）抑制性抗体依库珠单抗后，严重的、危及生命的血管内溶血迅速显著减少。自体/同种异体冷凝集素随后抑制与利妥昔单抗treatment.CONCLUSIONSEculizumab，一种有效的C5抑制性抗体，可以是一种快速和有效的治疗高溶血性输血反应时，给予足够的剂量，以完全阻断补体C5的激活。
BACKGROUNDHyperhemolysis in sickle cell disease is a rare and potentially life-threatening complication of transfusion.STUDY DESIGN AND METHODSIn this article we report a case of delayed hemolytic transfusion reaction with resultant hyperhemolysis triggered by an anti-IH autoantibody with alloantibody behavior.RESULTSThe anti-IH was reactive at room temperature as well as 37 degrees C, but only weakly reactive with autologous red blood cells. Initial cold agglutinin titer was 512. The profound, life-threatening, intravascular hemolysis was rapidly and dramatically reduced with the Complement 5 (C5) inhibitory antibody, eculizumab. The auto/allo cold agglutinin was subsequently suppressed with rituximab treatment.CONCLUSIONSEculizumab, a potent C5 inhibitory antibody, can be a rapid and effective therapy for hyperhemolytic transfusion reactions when given in a sufficient dose to fully block the activation of complement C5.