THE FIRST REPORTED CASE OF ANTI-DO(B) CAUSING AN ACUTE HEMOLYTIC TRANSFUSION REACTION

The antibodies of the Dombrock blood group system have only rarely bee n encountered in transfusion practice, and anti-Do(b) has not previous ly been implicated in an acute hemolytic transfusion reaction. We have encountered the first such case involving a chronically transfused bl ack female with hemoglobin SS disease and multiple antibodies in her s erum. During a previous admission for sickle cell crisis, the patient received 3 units of compatible blood with no untoward effects. Serum o btained 21 days later contained, in addition to the known antibodies, anti-S plus an unidentified antibody showing characteristics of HTLA. Blood lacking the E, K1, Fy(a), Jk(b) and S antigens was obtained, and 2 least incompatible units were transfused. While administering the s econd unit, the patient complained of fever and low back pain, and hem oglobinemia was detected. Anti-Do(b) was identified in the post-reacti on samples by absorption-elution tests, and the patient was confirmed to he Do(a+b-). The first unit transfused during this hemolytic episod e tested Do(b+). This case, and a similar case involving anti-Do(a) re ported in 1986, strengthens the belief that Dombrock antibodies are cl inically significant and iilustrates the need for their differentiatio n, prior to transfusion from less clinically significant HTLA antibodi es.