Hemolytic Transfusion Reaction Due To Anti - Jka - A Case Study

Abstract : BACKGROUND - Kidd system antibodies occur only as immune antibodies and are characteristically difficult to detect. They show variability in immunoglobulin class, sub-class and serological characteristics. Kidd antibodies are dangerous as they may cause severe acute hemolytic transfusion reaction and delayed hemolytic transfusion reaction. PATIENT AND METHODS - 54 year old male, a case of carcinoma prostate with the history of previous red cell transfusion was admitted to hospital for radiotherapy with severe anemia. On admission his hemoglobin level was 5.5 gmdl and Haematocrit was 18. The blood sample of the patient was sent to our Blood Bank for serologic testing since RBC transfusions were required. Blood grouping, Rh Typing and Coombs Cross-matching by tube method were done and one unit of A Rh (D) Positive packed RBCs was issued. The transfusion was interrupted after two and half hours because the patient complained of chills, lumbar pain, breathlessness and red color urine. Acute Haemolytic Transfusion Reaction was suspected and further evaluation was done to confirm the transfusion reaction. Direct Anti Human Globulin Test (DAT) was done. In the DAT positive sample, Eluate was prepared and performed Antibody identification by ID-Dia Med Gel Technique. RESULTS - In this study, the sample was positive for DAT and in the eluate Jka antibody was identified. CONCLUSION - The findings in our study show the importance of regular monitoring of the clinical effect of transfusion, even while transfusing coombs crossmatched blood.