Pseudo-hemolytic transfusion reaction: A case report and review of literature

• Main Authors: Shamee Shastry, Muralidhar V Pai
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Global Journal of Transfusion Medicine
• Subjects: blood transfusion; hematoma; hemolysis; transfusion reaction
• Online Access: http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2020;volume=5;issue=1;spage=87;epage=89;aulast=Shastry

A clinical syndrome that is consistent with intravascular hemolysis and that mimics hemolytic transfusion reaction is called pseudo-hemolytic transfusion reaction (PHTR). We present one such clinical scenario with PHTR. A 24-year-old patient was referred to our center with all the signs and symptoms of hemolytic reaction (HTR) on the second postoperative day following cesarean section. HTR was ruled out following a detailed transfusion reaction workup. Ultrasound abdomen was suggestive of gross ascites. Exploratory laparotomy showed large rectus sheet hematoma and hemoperitoneum. Internal bleeding and resolution of hematoma caused the signs and symptoms mimicking HTR in the present case. The literature review revealed the other causes of PHTR. Any adverse event occurring in temporal association with transfusion is a trigger for detailed reaction workup. In a case with PHTR, laboratory workup to rule out HTR is one of the important steps in patient management.