PMID- 21605202
OWN - NLM
STAT- MEDLINE
DCOM- 20111115
LR  - 20110707
IS  - 1365-3148 (Electronic)
IS  - 0958-7578 (Linking)
VI  - 21
IP  - 4
DP  - 2011 Aug
TI  - Haemolysis after treatment with intravenous immunoglobulin due to anti-A.
PG  - 267-70
LID - 10.1111/j.1365-3148.2011.01078.x [doi]
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) is used to treat an increasing 
      number of conditions. IVIG contains immunoglobulin G (IgG) directed against many 
      targets, including red blood cell (RBC) antigens. METHODS/MATERIALS: We report on 
      three patients identified within a 7-month period in a single institution who 
      developed haemolysis because of passively transferred anti-A. RESULTS: The 
      patients were a 34-year-old A (non-A1) D-positive male with aplastic anaemia, a 
      61-year-old A1 D-negative female with myasthenia gravis and a 57-year-old AB 
      D-positive female lung transplant recipient. The haemoglobin decreased from 11.1 
      to 5.3 g dL(-1) over 2 days, 12.8 to 7.8 g dL(-1) over 6 days and 7.8 to 6.0 g 
      dL(-1) over several hours, respectively. All three patients had a negative 
      antibody screen, positive direct antiglobulin test for IgG only and an elution 
      containing anti-A1 reactivity. The patients were transfused with O RBC with an 
      appropriate rise in haemoglobin. CONCLUSION: These cases illustrate the potential 
      severity of haemolysis after IVIG because of passively transferred antibodies to 
      blood group antigens. Lack of recognition of IVIG as a cause for haemolysis by 
      clinicians may be further confounded if routine testing fails to detect the 
      passively transferred ABO blood group antibodies.
CI  - (c) 2011 The Authors. Transfusion Medicine (c) 2011 British Blood Transfusion 
      Society.
FAU - Morgan, S
AU  - Morgan S
AD  - Department of Laboratory Medicine and Pathology, Division of Hematology, 
      Oncology, and Transplantation, University of Minnesota, Minneapolis, MN 55455, 
      USA.
FAU - Sorensen, P
AU  - Sorensen P
FAU - Vercellotti, G
AU  - Vercellotti G
FAU - Zantek, N D
AU  - Zantek ND
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20110523
PL  - England
TA  - Transfus Med
JT  - Transfusion medicine (Oxford, England)
JID - 9301182
RN  - 0 (ABO Blood-Group System)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - ABO Blood-Group System/blood/*immunology
MH  - Adult
MH  - Erythrocyte Transfusion
MH  - Erythrocytes/*immunology
MH  - Female
MH  - Hemolysis/*drug effects/immunology
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage/*adverse effects/*immunology
MH  - Isoantibodies/blood/*immunology
MH  - Male
MH  - Middle Aged
EDAT- 2011/05/25 06:00
MHDA- 2011/11/16 06:00
CRDT- 2011/05/25 06:00
PHST- 2011/05/25 06:00 [entrez]
PHST- 2011/05/25 06:00 [pubmed]
PHST- 2011/11/16 06:00 [medline]
AID - 10.1111/j.1365-3148.2011.01078.x [doi]
PST - ppublish
SO  - Transfus Med. 2011 Aug;21(4):267-70. doi: 10.1111/j.1365-3148.2011.01078.x. Epub 
      2011 May 23.