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MessagePosté le: Mar 1 Nov - 00:43 (2016)    Sujet du message: Hemolytic Transfusion Reaction Pdf Download Répondre en citant

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The cooperative study of sickle cell disease. Blackwell Publishing. Further research on genetic associations with DHTR will likely provide considerable help in elucidating risk factors, and perhaps information on the pathogenesis, of this syndrome. Clinical featuresThe clinical presentation of a DHTR in SCD may be quite similar to that of a sickle cell pain crisis, with or without features of an “aplastic crisis.” 6, 16–18 As a result, the diagnosis of a DHTR may be delayed because the anemia and pain are attributed to a pain crisis with “hyperhemolysis.” Indeed, the components of the sickle cell hemolytic transfusion reaction syndrome have been described (Table 1).19 In addition to the manifestations of acute or delayed hemolysis, patients typically exhibit symptoms of a pain crisis, marked reticulocytopenia (a decrease from the patient’s usual absolute reticulocyte count), and may develop a more severe anemia following transfusion than was present before.Table 1Components of Delayed Hemolytic Tranfusion Reactions*In light of these clinical features, it is important to include DHTR in the differential diagnosis of any SCD patient presenting with features of a typical or atypical pain episode and to inquire about recent transfusion history, particularly in patients who were recently hospitalized. [PubMed]27. 1990;76:14311437.

Transfusion. J Natl Med Assoc. v t e Complications of surgical and medical care (T80T88, 996999) Transfusion reactions Transfusion hemosiderosis TRALI TACO TA-GvHD FNHTR Acute/Delayed hemolytic transfusion reaction Vaccine injury Eczema vaccinatum Other Serum sickness Malignant hyperthermia Herxheimer reaction Graft-versus-host disease . Although clinical trials are lacking, a case report presented a patient with three prior episodes of DHTR for whom rituximab, a monoclonal antibody that targets B cells by binding CD20, allowed successful transfusion.27 This will likely be an active area of research in upcoming years.Minimizing RBC transfusion and the use of more extensive phenotypic matching of blood, particularly the Rh and Kell blood group systems,28 when transfusion is required are essential to decrease the risk of alloimmunization.7, 29 Although this is costly, transfused patients should receive at the minimum, leukocyte-reduced RBC units that are E-, C-, and Kell-negative.2, 3, 28, 30RBC transfusion can increase blood viscosity to a greater degree in patients with SCD than in normal patients, thereby paradoxically decreasing the oxygen-carrying capacity at some levels.2 As a result, every effort should be made to ensure that post-transfusion hemoglobin levels do not exceed 10–11g/dL. As patients with SCD have a shortened RBC survival, suppression of erythropoiesis has a profound effect on hemoglobin concentration compared to patients with normal red cell lifespan. Transfusion. HTTP Status 404 - . [PubMed]7. Transfusion.

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