A DELAYED HEMOLYTIC TRANSFUSION REACTION (DHTR) WITH MULTIPLE ALLOANTIBODIES (ANTI-E, JK(A), DI(A), FY(B), AND S) INDUCED BY E-ANTIGEN-NEGATIVE, CROSS-MATCH-COMPATIBLE BLOOD

We describe the case of a 44-year-old woman with a delayed hemolytic t ransfusion reaction (DHTR). She had a history of two pregnancies and a blood transfusion, the details of which were unknown. At the time of her first vascular surgery on November 15, 1989, she received 1200 ml of crossmatch-compatible concentrated red blood cells (CRC). Before th e first operation, screening for anti-RBC antibodies (Ab) was negative . At the time of the second admission on Feburary 15, 1996, anti-E Abs were detected by indirect antiglobulin test. She received 560 mi of E -antigen-negative, crossmatch-compatible, CRC for treatment of anemia on March 1 and 2, 1996. After this transfusion, total bilirubin (1.6 m g/dl) and lactate dehydrogenase (1355 IU/ml) were elevated on March 12 , 1996. She had no evidence of clinical hemolysis. We suspected DHTR f rom these data, and therefore screened for anti-RBC Abs. Anti-E, Jk(a) , Di(a), Fy(b), and S Abs were detected in blood samples obtained from the patient on March 12, 1996. Anti-E, Jk(a), Di(a), and S Abs were p resent more than 1 month and anti-Fy(b) Ab was disappeared at 18 days after transfusion.