Transfusion Medicine Case 76 May 3, 2023 pathadmin 528 Comments 1. Prepared by Alice Meiss, MD Reviewed by Lorraine N. Blagg, MA, MLS(ASCP)CMSBB An adult with a history of hematologic malignancy, currently undergoing treatment, is seen in clinic. They have received multiple RBC and platelet transfusions over the past few weeks. Their labs show a hemoglobin of 6.7 g/dL and a platelet count of 8 K/mm^3. They are pre-medicated with diphenhydramine and acetaminophen then transfused with one unit of A positive RBCs followed by two units of group O platelets. Their pre-transfusion temperature was 36.5 C and post-transfusion temperature is 38.0 C with other vital signs being within normal limits and no other reported signs or symptoms. You are contacted about a possible transfusion reaction with the following blood bank work-up: Clerical check is correct. Gram stain and culture RBC: Negative, no growth Gram stain and culture, platelet unit 1: Negative, no growth Gram stain and culture, platelet unit 2: Negative, no growth Additional labs were obtained showing: Post-transfusion hemoglobin: 7.6 g/dL Post-transfusion total bilirubin: 0.7 mg/dL Urinalysis showed 2 RBCs per HPF and was otherwise unremarkable Question What is your clinical impression of this suspected transfusion reaction?A.) Febrile non-hemolytic transfusion reaction with a new passive anti-A1 antibody due to transfusion of group O platelets.B.) Febrile non-hemolytic transfusion reaction. A passive anti-A1 antibody was present prior to the reaction and did not contribute to this event.C.) Delayed hemolytic transfusion reaction due passive anti-A1 antibody from transfusion of group O platelets.D.) Acute hemolytic transfusion reaction due to passive anti-A1 antibody from transfusion of group O platelets.E.) No evidence of a transfusion reaction. Loading...
