Blood transfusions leading to apparent hemoglobin C, S, and O-Arab hemoglobinopathies.

Abstract

CONTEXT:

Apparent hemoglobinopathies caused by blood transfusions rarely have been reported in the scientific literature.

OBJECTIVE:

To interpret the abnormal hemoglobins appearing as small peaks on hemoglobin chromatograms or electrophoresis membranes.

DESIGN:

In the clinical laboratories of a university hospital and a metropolitan hospital affiliated with a medical school, we interpreted hemoglobin chromatograms and electrophoresis membranes; correlated them with patients' medical, laboratory, and transfusion records; and when possible, identified the abnormal hemoglobin in the donors' transfusion segments.

RESULTS:

We detected 52 incidences of apparent hemoglobinopathies in 32 recipients caused by blood transfusion, of which 46 were hemoglobin C, 4 were hemoglobin S, and 2 were hemoglobin O-Arab. When first detected, the abnormal hemoglobins in recipients ranged from 0.8% to 14% (median, 5.6%). Multiple transfusions with abnormal hemoglobins occurred in 11 patients with 2 patients receiving hemoglobin C blood 5 separate times. One patient received hemoglobin C and later S, and another patient received C and later O-Arab.

CONCLUSIONS:

Apparent hemoglobinopathies caused by blood transfusions are far more common than previously reported and represent diagnostic challenges. Misdiagnosis could lead to unnecessary testing, treatment, and counseling. If a hemoglobinopathy from a unit of transfused blood is identified in a recipient, we recommend notifying the donor of that abnormality.

• Authors: Tzvetan B Kozarski, Peter J Howanitz, Joan H Howanitz, Nenad Lilic, Yeshpal S Chauhan
• Journal: Archives of pathology & laboratory medicine (Arch Pathol Lab Med) Vol. 130 Issue 12 Pg. 1830-3 (Dec 2006) ISSN: 1543-2165 [Electronic] United States
• PMID: 17149958 (Publication Type: Journal Article)

Chemical References

• Hemoglobin, Sickle
• Hemoglobins, Abnormal
• Hemoglobin C
• hemoglobin Arab

Topics

• Anemia, Sickle Cell (etiology, pathology)
• Chromatography, High Pressure Liquid
• Electrophoresis, Cellulose Acetate
• Hemoglobin C (analysis)
• Hemoglobin C Disease (etiology, pathology)
• Hemoglobin, Sickle (analysis)
• Hemoglobins, Abnormal
• Hospitals, University
• Hospitals, Urban
• Humans
• Transfusion Reaction