03105nas a2200373   4500008004100000020001400041024001700055245009500072210006900167260011700236300001200353490000700365520188500372653005202257653004402309653001502353653002602368653001802394653000902412653003702421653001102458653001102469653003202480653003202512653002002544653002602564653001602590653001502606100001602621700001602637700001702653700001602670856004502686       1998                        eng d  a0041-1132  awdn, 041736000aAn acute hemolytic transfusion reaction caused by an anti-P1 that reacted at 37 degrees C.0 aacute hemolytic transfusion reaction caused by an antiP1 that re  aUNITED STATESbArndt,P A. American Red Cross Blood Services, Southern California Region, Los Angeles, USA.c1998  a373 - 70 v383 aBACKGROUND: Hemolytic transfusion reactions (HTRs) due to anti-P1 have rarely been reported. There is only one report (from 1945) of an acute HTR due to anti-P1., CASE REPORT: A 74-year-old woman with anti-P1 was given blood that had been found to be compatible by the use of prewarmed serum and saline-suspended red cells (RBCs) and of an antiglobulin test with anti-IgG. The test mixtures were not centrifuged or inspected for agglutination after the 37 degrees C incubation phase. After transfusion of 50 mL of P1 + blood, the patient had an acute HTR (hemoglobinemia, hemoglobinuria, and increased blood pressure, temperature, and respiration)., RESULTS: When studied by a reference laboratory, the anti-P1 was shown to be easily detectable (3+ agglutination) by a prewarming technique (saline or low-ionic-strength saline [LISS]), which included centrifugation at 37 degrees C, but only weak reactions were observed when centrifugation after 37 degrees C incubation was omitted. The indirect antiglobulin test was weakly positive (1+) with anti-IgG, but polyspecific anti-human globulin reacted 2+. The anti-P1 agglutinin was IgM, and its titer was 16 at 37 degrees C (prewarmed) and 256 at 23 degrees C; it caused hemolysis of RBCs at 37 degrees C under conditions known to enhance hemolysis. An indirect monocyte monolayer assay gave results of 11.2 and 22 percent in testing of P1 + RBCs incubated with the patient's serum alone and with patient's serum plus fresh normal serum (as a source of complement), respectively (normal < or = 3%)., CONCLUSION: An acute HTR was caused by a hemolytic anti-P1 that reacted at 37 degrees C. This antibody was not detected by the hospital in a prewarmed crossmatch that omitted 1) the addition of LISS, 2) the reading for agglutination after the 37 degrees C incubation, and 3) the use of antiglobulin sera containing anti-complement.10a*Blood Group Incompatibility/co [Complications]10a*Blood Transfusion/ae [Adverse Effects]10a*Hemolysis10a*P Blood-Group System10aAcute Disease10aAged10aBlood Grouping and Crossmatching10aFemale10aHumans10aImmunoglobulin G/bl [Blood]10aImmunoglobulin M/bl [Blood]10aMercaptoethanol10aOsmolar Concentration10aTemperature10aTitrimetry1 aArndt, P, A1 aGarratty, G1 aMarfoe, R, A1 aZeger, G, D  uhttp://613633.bywedr.asia/reference/4245