A 45-year-old woman with a history of iron deficiency anemia is admitted for a blood transfusion due to symptomatic anemia. About 30 minutes after receiving a unit of packed red blood cells, she develops fever 38.5°C, chills, and mild discomfort, but no rash, hypotension, or dyspnea. Her vitals remain stable, and physical examination does not reveal signs of an allergic reaction or hemolysis. Laboratory tests show: Hemoglobin: 9.8, WBC: 7,500/mm³, Platelet count: 250,000/mm³, LDH: Elevated, Haptoglobin: Low. Direct Coombs test: Positive. Urinalysis: Hemoglobinuria (no RBCs on microscopy). What is the most likely diagnosis?
سؤال مجاني 8 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Acute Hemolytic Transfusion Reaction
Fever and chills during the transfusion plus laboratory evidence of hemolysis (high LDH, low haptoglobin, hemoglobinuria without RBCs, positive direct Coombs) define an acute hemolytic transfusion reaction (ABO incompatibility).
- FNHTR also causes fever/chills but has no hemolysis — normal DAT, haptoglobin and urine.
- Anaphylaxis (hypotension, bronchospasm) and TRALI (hypoxia, bilateral infiltrates) do not fit.
- المصدر
- 4_5933925733821844160 (2) (3).pdf · p. 3
transfusion notes v2.pdf · p. 2 - المحاضرة
- Transfusion Medicine · Hematology · Module C
- ظهر في
- MED42 ♂ EOM C