Abstract:
BACKGROUND:Jra is a high-frequency antigen seen in all populations, but the clinical significance of Jra antibodies is incompletely understood. Two cases are reported in which patients with anti-Jra received incompatible transfusions. CASE REPORTS:A 69-year-old Japanese man had anti-K and anti-Jra. Despite multiple transfusions of Jr(a+), K- RBCs, his clinical course remained stable without evidence of hemolysis. A 45-year-old Japanese woman with anti-Jra was transfused with two units of Jr(a+) RBCs without clinical evidence of hemolysis. However, the same patient received an additional unit of Jr(a+) RBCs 1 week after the initial transfusions and, within 6 hours of transfusion, developed signs and symptoms of an acute hemolytic transfusion reaction. STUDY DESIGN AND METHODS:Routine serologic methods were used to study the patients' RBCs and plasma. A monocyte monolayer assay (MMA) was used to determine the potential clinical significance of the anti-Jra, where reactivity (R) greater than 5 percent indicates potential clinical significance. RESULTS:The anti-Jra in the first case had a pretransfusion titer of 32 with a MMA result of 3.3 percent R. No clinical or laboratory evidence of hemolysis was seen after transfusion of 4 units of Jr(a+), K- RBCs. The anti-Jra in the second case had a pretransfusion titer of 32 with a MMA result of 24.5 percent R. This patient developed an acute hemolytic reaction after transfusion of Jr(a+) RBCs. CONCLUSION:Anti-Jra can be clinically significant as demonstrated by acute hemolysis in the second case. The MMA accurately predicted the clinical outcome of each case and appears to be a useful tool in predicting the biologic behavior of anti-Jra.
journal_name
Transfusionjournal_title
Transfusionauthors
Kwon MY,Su L,Arndt PA,Garratty G,Blackall DPdoi
10.1111/j.1537-2995.2004.00643.xsubject
Has Abstractpub_date
2004-02-01 00:00:00pages
197-201issue
2eissn
0041-1132issn
1537-2995pii
643journal_volume
44pub_type
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