Fatal hyperhemolytic delayed transfusion reaction in sickle cell disease: A case report and literature review

Patients with sickle cell disease (SCD) may require repeated red blood cells (RBCs) transfusion, putting them at risk for minor blood group alloimmunization and the development of hyperhemolytic delayed transfusion reactions (HDTR). We recently cared for an adolescent with SCD who was admitted to the hospital with a severe HDTR. The patient had been discharged from the hospital five days previously, and had been transfused while hospitalized. The patient continued to hemolyse, despite the use of antigen compatible blood and end-up by disseminated intravascular coagulopathy (DIC), acute kidney injury (AKI) and he went on to develop cardiac arrest and could not be resuscitated. In addition to demonstrating the potential severity of HDTR we are focusing on potential side effects of transfusion therapy in SCD. Physicians caring for patients with SCD should be aware of the unique complications and transfusion requirements in this population. HDTR is a potentially life-threatening complication. It is of crucial that when a patient presents with symptoms of a painful episode with worsening anemia and has a history of recent transfusion, the clinician be alert to the possibility of a HDTR.