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A hemolytic transfusion reaction due to Anti-Ku antibody in a patient with Knull phenotype: the first case in Korea.

Authors
Kang, MG; Lim, YA; Lee, KM
Citation
The Korean journal of laboratory medicine, 29(3):238-242, 2009
Journal Title
The Korean journal of laboratory medicine
ISSN
1598-6535
Abstract
Knull phenotype completely lacks all Kell system antigens. Anti-Ku antibody is seen in immunized persons with Knull phenotype by transfusion or pregnancy. It can cause a fatal hemolytic transfusion reaction. A 66-yr-old male patient with liver cirrhosis visited emergency center due to acute bleeding. The patient was at hypovolemic shock status: his blood pressure was 80/50 mmHg, pulse rate was 110/min and hemoglobin level was 4.4 g/dL. Because of the presence of antibody against high incidence antigen, we could not find any compatible blood for the patient. Nevertheless, 4 units of packed RBCs had to be transfused. Moderate hemolytic transfusion reaction was developed after transfusion. At endoscopic examination, blood was spurting from gastric cardiac varix. Endoscopic histoacryl injection was tried, and bleeding was successfully controlled. After bleeding stopped, he was managed for anemia using steroid and other medical therapy instead of transfusion. His hemoglobin level was improved to 7.7 g/dL at the time of discharge. Later he has been proved to have a Knull phenotype, which is very rare, and anti-Ku antibody. This report is the first case of anti-Ku in a Knull phenotype person in Korea, who experienced a moderate hemolytic transfusion reaction.
MeSH terms
AgedAntigens, Nuclear/immunology*Blood Group IncompatibilityBlood Transfusion/adverse effects*DNA-Binding Proteins/immunology*HumansIsoantibodies/bloodKell Blood-Group System/genetics*KoreaMalePhenotype
DOI
10.3343/kjlm.2009.29.3.238
PMID
19571622
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Laboratory Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
AJOU Authors
임, 영애이, 기명
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