Case 19 Part 1

1. Presented by Eric A. Gehrie, MD and prepared by Lorraine N. Blagg, MA, MLS(ASCP)SBB

Clinical Vignette

The patient is an adult female with a history of hemoglobin SC disease, who was referred to the emergency department from an outpatient clinic for complaints of headaches and pain in her legs and back. It was determined she had pneumonia and was diagnosed with acute chest syndrome and an automated red cell exchange was planned.

Hematology Lab results:

  • WBC: 16.49 K/cu mm

  • Hemoglobin: 11.4 g/dl

  • Hematocrit: 32.0%

  • Retic count: 2.7%

  • Hemoglobin S: 43.4%

  • Hemoglobin C: 45.2%

  • Hemoglobin F: 4.6%

Transfusion Medicine Lab results:

  • ABO/Rh type: AB Neg

  • Antibody Screen: Negative

  • Blood requirements: Leukoreduced & Sickle trait negative

During the red cell exchange with A Negative RBCs, the patient experienced headache, lightheadedness, tingling in the mouth, and abdominal discomfort and cramping.

What type of transfusion reaction may this patient be experiencing?