背景:镰状细胞病(SCD)影响美国约100,000人和全球数百万人,在非洲种族个体中发现的SCD患病率最高,为70%。迟发性溶血,同种免疫,需要对多次输血患者的记忆性输血反应进行调查和管理,以避免患者的临床状况恶化。
目的:本文旨在研究在巴西亚马逊地区多输血的SCD患者的延迟输血反应。
方法:对输血4次以上的SCD患者的临床和实验室指标进行调查。这些患者在亚马逊血液病医院接受治疗,巴西。
结果:共随访了44例多输血SCD患者。关于Rh表型,可以观察到26.6%(12)的RZRZ(DCE/DCE)表型患者的频率,除了4.5%(2)RH和RHCE变异的患者。还可以观察到20.5%(9)的同种免疫反应患者,他提出了以下同种抗体:抗RhD,反E,反K,反Jkb,反N,反S,和反Dia,其中两个身份不明。其中,四名(44.4%)患者也出现自身抗体,反e,和三种身份不明的抗体,四名(44.4%)患者出现记忆障碍反应,反RHD,K,和Jkb抗体。在接受监测的44名患者中,54.4%(24)的临床和实验室指标为延迟的溶血反应。
结论:延迟输血反应,经常被忽视,经常发生。因此,输血需要监测至少28天,与临床和实验室指标的医学调查,以更多地利用这种治疗资源。
BACKGROUND: Sickle cell disease (SCD) affects approximately 100,000 people in the United States and millions worldwide, with the highest prevalence of 70% of SCD being found in individuals of African ethnicity. Delayed hemolytic, alloimmunization, and anamnestic transfusion reactions in multiple transfusion patients need to be investigated and managed to avoid a worsening of the patient\'s clinical status.
OBJECTIVE: This paper aims to investigate delayed transfusion reactions in SCD patients who were polytransfused in the Brazilian Amazon.
METHODS: The clinical and laboratory indicators of SCD patients with more than four transfusions were investigated. The patients were treated at the Fundação Hospitalar de Hematologia e Hemoterapia do Estado do Amazonas, Brazil.
RESULTS: A total of 44 polytransfused patients with SCD were followed. Regarding Rh phenotype, it was possible to observe a frequency of 26.6% (12) patients with the RZRZ (DCE/DCE) phenotype, in addition to 4.5% (two) patients with RH and RHCE variants. It was also possible to observe 20.5% (nine) patients with an alloimmunization reaction, who presented the following alloantibodies: anti-RhD, anti-E, anti-K, anti-Jkb, anti-N, anti-S, and anti-Dia, two of which are unidentified. Of these, four (44.4%) patients also presented autoantibodies, anti-e, and three unidentified antibodies, and four (44.4%) patients presented an anamnestic reaction, with anti-RhD, K, and Jkb antibodies. Of the 44 patients monitored, 54.4% (24) had clinical and laboratory indicators of a delayed hemolytic reaction.
CONCLUSIONS: Delayed transfusion reactions, often neglected, occur frequently. Therefore, transfusions need to be monitored for at least 28 days, with medical investigation of clinical and laboratory indicators to make greater use of this therapeutic resource.