How a transfusion medicine consultation became a life-saving intervention for an E-Beta thalassemia patient: A case report from Kolkata, West Bengal

Abstract

Bedside transfusion practice is a challenge for Transfusion Medicine practitioners in multi-transfused patients who have irregular antibody(s) against donors red cell antigens. Apart from ABO and Rh, there are more than 300 identified blood group antigens present on the surface of red cell membrane. We present a patient of E-Beta thalassemia in 36 weeks of gestation who is nontransfusion-dependent thalassemic. She had received two units of concentrated red blood cells (RBCs) 2 years back during the birth of her first child by cesarean section. She was severely pale when she attended the obstetrics outpatients' department for her second pregnancy. Urgent transfusion of two units of ABO-matched packed RBCs worsened the anemia and jaundice. Instead of hemoglobin increment, fall of Hb with cola colored urine occurred within a short period. Antibody identification was done, and antibody negative red cell transfusion was given which helped the obstetrician for safe delivery and well-being of the mother.

Keywords

• Cesarean section
• direct antiglobulin test
• indirect antiglobulin test
• nontransfusion dependent thalassemia
• red blood cell