A 40-year-old woman, gravida 4 para 4, comes to the clinic due to anemia. A week ago, the patient was seen in the emergency department due to fatigue, shortness of breath, and increasingly heavy, irregular menses. Laboratory evaluation showed a hemoglobin level of 5.4 g/dL. After a transfusion with packed red blood cells, her follow-up hemoglobin level was 7.8 g/dL prior to discharge. Since then, the patient's energy and breathing have improved, and she has had no further menstrual bleeding. However, yellowing of the eyes and face has developed over the last day. Vital signs are normal. Examination reveals scleral icterus. There is no hepatosplenomegaly. Laboratory results are as follows: This patient's current symptoms are most likely due to which of the following antibody-antigen reactions?

Question

A 40-year-old woman, gravida 4 para 4, comes to the clinic due to anemia.  A week ago, the patient was seen in the emergency department due to fatigue, shortness of breath, and increasingly heavy, irregular menses.  Laboratory evaluation showed a hemoglobin level of 5.4 g/dL.  After a transfusion with packed red blood cells, her follow-up hemoglobin level was 7.8 g/dL prior to discharge.  Since then, the patient's energy and breathing have improved, and she has had no further menstrual bleeding.  However, yellowing of the eyes and face has developed over the last day.  Vital signs are normal.  Examination reveals scleral icterus.  There is no hepatosplenomegaly.  Laboratory results are as follows:  This patient's current symptoms are most likely due to which of the following antibody-antigen reactions?

Quizplus · Accepted Answer

Eductional Objective: Delayed hemolytic transfusion reactions are usually mild, hemolytic reactions that occur >24 hours after blood transfusion.  They are a type of anamnestic response (delayed immunologic response) that occurs in patients previously exposed to a minor RBC antigen (eg, previous blood transfusion, pregnancy).

A 40-Year-Old Woman, Gravida 4 Para 4, Comes to the Clinic