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Autoimmune haemolytic anaemia: emergency blood transfusion
  1. Sian Angela Nasse
  1. Hywel Dda Health Board, Aberystwyth, UK
  1. Correspondence to Dr Sian Angela Nasse; SianNasse{at}doctors.org.uk

Abstract

A 50-year-old woman, with a background of autoimmune haemolytic anaemia, presented to the emergency department with lethargy and shortness of breath. Investigations revealed a haemoglobin level of 50 g/L. High dose steroids were administered and blood transfusion prescribed. However, the blood transfusion was delayed due to a positive antibody screen and concerns regarding administering blood when the patient was pyrexic. The delay resulted in a significant deterioration in the patient’s clinical state with her haemoglobin level falling to 26 g/L 24 hours later. She was urgently transfused with blood and made a full recovery. This report analyses the delays for transfusion and how these could have been minimised. First, guidelines advise that emergency blood should be considered in life-threatening circumstances. Second, fever is not always a contraindication for transfusion, particularly in an emergency setting.

  • haematology (drugs and medicines)
  • haematology (incl blood transfusion)
  • healthcare improvement and patient safety
  • malignant and benign haematology
  • pulmonary embolism

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Footnotes

  • Contributors Myself as the sole author, SAN, is accountable for all aspects of work on the report. Three doctors proof read the report, whom are included in the Acknowledgements section.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.