Download Slide 1 - isbtitn

Dr. Y. Swapna
Rotary Central TTK VHS Blood Bank
Chennai – 600 113.
• IS Blood Transfusion safe in Auto immune
Hemolytic Anemia?
• We have several referral cases of AIHA,
We have successfully issued least
incompatible Blood units; in most cases,
the incompatibility grading was very much
less severe compared to auto control.
There were no untoward reactions or
problems in the patients and the
hemoglobin was also found to increase .
• A 40 year old female patient was posted
for hysterectomy (for menorrhagia due to
Fibroid uterus) with Hb 7gms%
• She was suggested Blood Transfusion to
increase Hb. There is previous history of
uneventful whole Blood Transfusion for
anemia, about 6 months back.
• Now she could not obtain compatible
Blood units in any centre and hence was
referred to VHS.
• OnTesting: - Auto Control (Ig G phase) and
Direct Coomb’s Tests were positive.
• The Blood units were cross matched by
comprehensive compatibility Techniques.
• Incompatibility was observed by Bovine
Albumin, Room Temperature, 37.C. and Indirect
Coomb’s Technique.
• The antibody detected on 3 cell panel and 11
cell panel was found to be anti – e. Titre is
1:256
• Other parameters suggestive of hemolysis are
normal
• Noh/o Drug Intake,
• Infections Ruled out.
• SLE,RA,CLL were ruled out.
• Result: - Warm type of anti body of Rh
specificity acting against self antigen ‘e’, also
documented to act as allo antibody.
• Discussion: - In few cases of AIHA,
Blood units were issued if found to be
least incompatible; after cross matching
many units. In this case, this was not
possible as the incompatibility was severe.
So the Hematologist suggested immuno
suppressives, hematinics and autologous
Transfusion.
• Conclusion: - This is a case of idiopathic
warm type of AIHA., Blood Transfusion
would be ideal with the corresponding
antigen negative blood unit. If not
available, least incompatible blood units
and corticosteroids form the basis of
treatment ,based on the severity of
anemia.
• References : - Mollison’s Blood Transfusion
in clinical practice 11th Edition
•
: de Gruchy’s Clinical
• Hematology in medical Practice 5th Edition
•
: AABB Technical Manual,
14th Edition.
•
: A manual of Hemotherapy
•
Thank you