患者发生 alloanti-Ge3 所致温和型急性溶血性输血反应：病例报告及文献复习

A mild acute hemolytic transfusion reaction in a patient with alloanti-Ge3: a case report and review of the literature.

机构信息

Department of Pathology, University of California, San Diego, La Jolla, CA 92093-0960, USA.

出版信息

Transfusion. 2011 Sep;51(9):1966-71. doi: 10.1111/j.1537-2995.2011.03093.x. Epub 2011 Mar 10.

DOI:10.1111/j.1537-2995.2011.03093.x

PMID:21392022

Abstract

BACKGROUND

The clinical significance of the Gerbich antibodies has been described as variable and there are no well-documented reports of hemolytic transfusion reactions (HTRs).

CASE REPORT

We present the case of a woman with a long history of documented anti-Ge3 alloantibody who received multiple units of Ge+ red blood cells (RBCs) uneventfully. During the first admission to our hospital she was transfused 8 units of Ge+ RBCs and had a negative monocyte monolayer assay (MMA) before receiving the units. Within 2 weeks of the transfusions, the anti-Ge3 became significantly stronger by indirect antiglobulin test, and the MMA increased from 2.2 to 79.5% reactivity. She returned 4.5 years later with an emergent need for blood and was transfused with 2 units of Ge+ RBCs after premedication with steroids and intravenous immunoglobulin.

RESULTS

The first unit was transfused without incident; however, she developed clinical and laboratory signs consistent with an acute HTR with the second unit.

CONCLUSION

After a comprehensive review of the literature, we believe this to be the first well-documented case of acute HTR due to anti-Gerbich alloantibodies.

摘要

背景

关于 Gerbich 抗体的临床意义已有描述，但其导致溶血性输血反应（HTR）的证据并不充分。

病例报告

我们报告了一例具有明确抗-Ge3 同种异体抗体病史的女性患者，她曾多次输注 Ge+红细胞（RBC），未发生任何不良事件。第一次住院期间，她接受了 8 单位的 Ge+ RBC，且在输注前进行了单核细胞单层试验（MMA），结果为阴性。输血后 2 周内，间接抗球蛋白试验显示抗-Ge3 明显增强，MMA 从 2.2%增加至 79.5%。4.5 年后，她因紧急需要输血，在预先给予类固醇和静脉注射免疫球蛋白后输注了 2 单位的 Ge+ RBC。