Abstract
A 12-year-old male child was presented in the emergency with features of anemia and mild icterus on day+67 of HSCT. The child was suffering from Fanconi anemia and undergone HSCT from ABO-matched, fully HLA matched sibling donor. The diagnosis of mixed type AIHA due to cytomegalovirus reactivation was made in the immunohematology laboratory and blood group discrepancy was the first sign of AIHA in this patient. Though the cold agglutinin titer was not significant but the clinical symptoms and laboratory evidences were suggestive of significant hemolysis due to underlying IgG autoantibody. In addition the high complement avidity of IgM autoantibody might also be a contributing factor for clinically significant hemolysis in this case. The patient was successfully treated with phenotype matched blood transfusion, rituximab and oral steroid therapy.
References
Petz LD (2005) Immune hemolysis associated with transplantation. Semin Hematol 42:145–155
Wang M, Wang W, Abeywardane A et al (2015) Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: analysis of 533 adult patients who underwent transplantation at King’s College Hospital. Biol Blood Marrow Transplant 21(1):60–66
Ahmed I, Teruya J, Murray-Krezan C, Krance R (2015) The incidence of autoimmune hemolytic anemia in pediatric hematopoietic stem cell recipients post-first and post second hematopoietic stem cell transplant. Pediatr Transplant 19(4):391–398
Faraci M, Zecca M, Pillon M et al (2014) Autoimmune hematological diseases after allogeneic hematopoietic stem cell transplantation in children: an Italian multicenter experience. Biol Blood Marrow Transplant. 20:272–278
O’Brien TA, Eastlund T, Peters C et al (2004) Autoimmune haemolytic anaemia complicating haematopoietic cell transplantation in paediatric patients: high incidence and significant mortality in unrelated donor transplants for non-malignant diseases. Br J Haematol 127(1):67–75
Horn B, Viele M, Mentzer W et al (1999) Autoimmune hemolytic anemia in patients with SCID after T cell depleted BM and PBSC transplantation. Bone Marrow Transplant 24(9):1009–1013
Leger RM (2014) The positive direct antiglobulin test and immune-mediated hemolysis. In: Fung MK, Grossman BJ, Hillyer CD, Westhoff CM (eds) Technical manual. AABB, Bethesda, pp 425–451
Judd WJ, Johnson S, Storry J (2008) Judd’s methods in immunohematology, 3rd edn. AABB Press, Bethesda, p 137
Daikeler T, Tyndall A (2007) Autoimmunity following haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 20:349–360
Sherer Y, Shoenfeld Y (1998) Autoimmune diseases and autoimmunity post-bone marrow transplantation. Bone Marrow Transplant 22:873–881
Raj A, Bertolone S, Cheerva A et al (2004) Successful treatment of refractory autoimmune hemolytic anemia with monthly rituximab following nonmyeloablative stem cell transplantation for sickle cell disease. J Pediatr Hematol Oncol 26(5):312–314
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Datta, S.S., Reddy, M., Basu, S. et al. Blood Group Discrepancy-First Sign of Autoimmune Hemolytic Anemia after Hematopoietic Stem Cell Transplantation in a Child. Indian J Hematol Blood Transfus 32 (Suppl 1), 211–213 (2016). https://doi.org/10.1007/s12288-015-0630-2
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DOI: https://doi.org/10.1007/s12288-015-0630-2