Blood Transfusion in Premature or Young Infants with Polyagglutination and Activation of the T Antigen

Engelfriet, C. P.; Reesink, H. W.; Strauss, Ronald G.; Luban, Naomi L.C.; Letsky, Elizabeth A.; Modi, Neena; Zupańska, B; Leeuwen, E. F. Van; Martín‐Vega, Carmen; Krusius, Tom

doi:10.1046/j.1423-0410.1999.76201281.x

Cited by 16 publications

(29 citation statements)

References 11 publications

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“…Although T activation has been detected on the RBCs of up to 30% of neonates who have NEC, clinical haemolysis rarely is observed. 15 , 16 Four percent of the patients had haemosiderin and haematuria but without clinical evidence of worsening haemolysis.…”

Section: Discussionmentioning

confidence: 99%

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Ayede¹,

Akingbola²

2011

Ann. Ibadan Postgrad. Med.

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Background and objectives:There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period, there is paucity of local data on the pattern, indications and reactions to blood transfusions in Nigerian newborns. This study evaluates the blood transfusion indications and patterns in special care baby unit and C12nd of University College Hospital, Ibadan, Nigeria.Methodology:A cross sectional study was carried on the recruited newborns and structured questionnaires were used to obtain bio data, medical problems, indications for blood transfusion, type of blood products transfused and clinical signs. Urinalysis was performed out before and after the transfusion.Results:A total of 100 neonates were recruited into the study with a male: female ratio of (M: F= 1:1). The age range was 2–34 days and their weight ranged between 0.8kg to 3.6 kg with a mean weight of 1.64 kg. The main indications for transfusion were anaemia from prematurity & neonatal sepsis(NNS) 46%; (red cell replacement), NNS, Disseminated intravascular coagulation(DIC) & anaemia 24%; (partial exchange + top up + Fresh frozen plasma), neonatal jaundice(NNJ) & anaemia 14%; (whole blood), NNJ, NNS + anaemia 6%(Blood transfusion + Fresh frozen plasma), NNS + anaemia 10% (whole blood).Conclusion:Blood transfusion is still frequent in the study area and prematurity, neonatal sepsis and jaundice rank high in the indications. Transfusion reactions are rare in the evaluated neonates.

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Section: Discussionmentioning

confidence: 99%

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Ayede¹,

Akingbola²

2011

Ann. Ibadan Postgrad. Med.

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“…The recent decrease in the mortality rate has been attributed to a number of factors, including early recognition of the disease and judicious use of blood products [21,42]. Recently, some investigators have questioned the risk of transfusing plasma in patients demonstrating T-activation [24,26,43]. Others have suggested that these events are the result of infection with a verocytotoxin-producing strain of S. pneumoniae, and not the result of neuraminidase activity [44,45,46,47].…”

Section: Discussionmentioning

confidence: 99%

Pneumococcus-induced T-antigen activation in hemolytic uremic syndrome and anemia

Cochran

Panzarino

Maes

et al. 2004

Pediatric Nephrology

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The hemolytic uremic syndrome (HUS) is most commonly associated with Escherichia coli, but has been associated with other infections such as Streptococcus pneumoniae. Pneumococcus-induced HUS carries an increased risk of mortality and renal morbidity compared with E. coli-induced HUS. The pneumococcal organism produces an enzyme, which can expose an antigen (T-antigen) present on erythrocytes, platelets, and glomeruli. Antibodies to the T-antigen, normally found in human serum, bind the exposed T-antigen, and the resultant antigen-antibody reaction (T-activation) can lead to HUS and anemia. Clinicians need to be aware to request specific testing when pneumococcus-induced HUS/anemia is suspected, as current blood banking techniques do not routinely test for the presence of the T-antigen. Once this association is documented, washing all blood products and avoiding plasma products, if possible, is recommended. Plasmapheresis can be considered for the more critically ill patient. The incidence of pneumococcus-induced HUS may be increasing. We report six cases of pneumococcus-induced HUS/anemia presenting at our hospital.

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“…Several reports of hemolysis after the transfusion of plasma‐containing blood components in patients with T activation attributed to the anti‐T IgM antibodies present in the donor plasma have led to recommendations for screening for T‐activation in patients with NEC and the routine avoidance of plasma products for infants with NEC and RBCs displaying T activation . However, the causal relationship between T activation and hemolysis has been called into question by many clinicians and serologists . These doubts are based on the rarity of clinical problems in infants with NEC receiving plasma or plasma‐containing components, reports of the transfusion of blood products containing anti‐T antibodies in patients with RBCs displaying T activation with no evidence of significant hemolysis, and the serologic properties of anti‐T antibodies.…”

mentioning

confidence: 99%

Severe hemolysis after plasma transfusion in a neonate with necrotizing enterocolitis, Clostridium perfringens infection, and red blood cell T‐polyagglutination

et al. 2017

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Blood Transfusion in Premature or Young Infants with Polyagglutination and Activation of the T Antigen

Cited by 16 publications

References 11 publications

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Pneumococcus-induced T-antigen activation in hemolytic uremic syndrome and anemia

Severe hemolysis after plasma transfusion in a neonate with necrotizing enterocolitis, Clostridium perfringens infection, and red blood cell T‐polyagglutination

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