APIB223886222- CME/CMLE - A Case Study Involving Transfusion Reaction-APIB223886222

APIB223886222 - Educational Activity

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The document is an educational commentary provided by Susanne Bishop concerning a case study on transfusion reactions. The detailed case involves a 55-year-old female patient with a history of bleeding ulcers, presenting symptoms of dizziness, fatigue, and stomach pain, leading to an anemia diagnosis. Initial and follow-up tests, including a CBC and antibody screens, formed the core of the transfusion work-up, including a complex sequence of crossmatches and tests logged over several days and encounters.<br /><br />The patient was identified to have a blood type of B positive with no prior clinically significant antibodies. After an initial transfusion of two units of red blood cells (RBCs), four days later, the patient exhibited symptoms of a delayed hemolytic transfusion reaction (DHTR). A secondary antibody screen and direct antiglobulin test (DAT) indicated the presence of anti-Jka antibodies.<br /><br />The commentary explains the scientific and procedural details of differentiating and identifying transfusion reactions, particularly focusing on acute (occurring within 24 hours) and delayed reactions (occurring after 24 hours). It emphasizes the need for meticulous procedures including clerical checks, repeat ABO testing, visual inspections for hemolysis, DAT, and additional antibody screens.<br /><br />The case study illustrates the procedural rigor required, particularly when considering the rapid decline of antibodies like anti-Jka in vivo which can complicate detection. Therefore, regular updates to patient records and stringent control checks are essential to prevent adverse reactions. The commentary ends by reinforcing the regulatory steps that need to be followed strictly whenever a transfusion reaction is suspected to minimize risks and ensure patient safety.<br /><br />The document also includes CME questions to evaluate the understanding of transfusion reactions, focusing on practical assessments such as reasons for the association of anti-Jka with hemolytic reactions, understanding mixed-field reactivity, symptoms of delayed hemolytic transfusion reactions, and the necessary crossmatches required when clinically significant antibodies are present.

Keywords

transfusion reactions

delayed hemolytic transfusion reaction

anti-Jka antibodies

acute transfusion reactions

anemia diagnosis

crossmatches

direct antiglobulin test

CME questions

patient safety

antibody screens