Mintz P D, Williams M E
Ann Clin Lab Sci. 1986 May-Jun;16(3):214-8.
A 28-year-old woman with sickle cell anemia suffered a left hemispheric cerebrovascular accident associated with severe right-sided weakness during a delayed hemolytic transfusion reaction owing to anti-rh' (C) and anti-S. The anti-rh' (C) had been identified four years earlier at a different hospital but neither the patient, her family, nor any member of the staff of the hospital where she was transfused was aware of this information. It is postulated that spherocytes, formed during hemolysis, could slow capillary flow, thereby increasing red cell sickling and producing vaso-occlusion. The patient had no clinically apparent neurologic complications during the preceding 24 years and has had no further neurologic events during the subsequent 20 months. This patient's reaction underscores the compelling need for sensitive pre-transfusion tests as well as the obligation to inform patients and their families of the presence and potential consequences of alloantibodies in the event of future transfusion.
一名28岁的镰状细胞贫血女性在因抗rh'（C）和抗-S导致的延迟性溶血性输血反应期间，发生了左半球脑血管意外，并伴有严重的右侧肢体无力。抗rh'（C）在四年前于另一家医院被发现，但患者本人、其家人以及她接受输血所在医院的任何工作人员都不知道这一信息。据推测，溶血过程中形成的球形红细胞可能会减缓毛细血管血流，从而增加红细胞镰变并导致血管闭塞。该患者在之前的24年中没有明显的临床神经并发症，在随后的20个月中也没有发生进一步的神经事件。该患者的反应强调了进行敏感的输血前检测的迫切需求，以及在未来输血时告知患者及其家属同种抗体的存在和潜在后果的义务。
