Delayed Hemolytic Transfusion Reaction With Hyperhemolysis Syndrome Due to Anti-M Alloantibody in Myelofibrosis: A Case Report

Hyperhemolysis syndrome (HHS) and delayed hemolytic transfusion reaction (DHTR) commonly occur in patients with sickle cell disease (SCD) and thalassemia, due to the need for recurrent red blood cell (RBC) transfusion, but rarely in patients with myelofibrosis. HHS is a life-threatening condition th...

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Bibliographic Details
Published in:Cureus 2023-12, Vol.15 (12), p.e50717-e50717
Main Authors: Alsoreeky, Mohammad S, Lutfi, Laith K, Altamimi, Ahmad A, Haddad, Tamer H, Khalayleh, Mashael S, Alkader, Mohammad S
Format: Article
Language:English
Subjects:
Abdomen
Anemia
Antibodies
Apheresis
Biopsy
Blood diseases
Bone marrow
Case reports
Chronic illnesses
Dehydrogenases
General Surgery
Hematology
Hemoglobin
Laboratories
Medical imaging
Oncology
Pathophysiology
Patients
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Summary:Hyperhemolysis syndrome (HHS) and delayed hemolytic transfusion reaction (DHTR) commonly occur in patients with sickle cell disease (SCD) and thalassemia, due to the need for recurrent red blood cell (RBC) transfusion, but rarely in patients with myelofibrosis. HHS is a life-threatening condition that occurs with or without DHTR, in which both transfused and autologous RBCs are destroyed. It needs a high clinical suspicion for diagnosis, especially when there is a drop in hemoglobin level to the level of pretransfusion of RBCs, accompanied by hyperbilirubinemia and reticulocytopenia. The management of HHS includes avoiding RBC transfusion, supportive care, and immunomodulatory therapy. We present a case of HHS with DHTR in a patient with primary myelofibrosis who was treated successfully with steroids and splenectomy.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.50717