Case 101

1. Presented by Matthew Gabrielson, MD and reviewed by Lorraine N. Blagg, MA, MLS(ASCP)SBB

Clinical Vignette

An elderly adult patient with hypertension is admitted for a myomectomy for uterine fibroids. The patient's history is also significant for a motor vehicle accident several years prior, requiring multiple blood products. During the procedure, the patient requires two units of RBCs and one unit of platelets for bleeding. The post-operative course is otherwise unremarkable, and the patient is discharged two days after the procedure. Approximately one week later, the patient presents to the Emergency Department with mucosal (gums) bleeding and diffuse bruising. Blood is drawn for labs (CBC and chemistry panel), the results of which are below.

The patient is admitted and started on IVIG at 1g/kg.

If an RBC transfusion is needed, what product modifications would you consider?