Haemolysis after treatment with intravenous immunoglobulin due to anti-A

S. Morgan, P. Sorensen, G. Vercellotti, N. D. Zantek

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Intravenous immunoglobulin (IVIG) is used to treat an increasing number of conditions. IVIG contains immunoglobulin G (IgG) directed against many targets, including red blood cell (RBC) antigens. Methods/materials: We report on three patients identified within a 7-month period in a single institution who developed haemolysis because of passively transferred anti-A. Results: The patients were a 34-year-old A (non-A1) D-positive male with aplastic anaemia, a 61-year-old A1 D-negative female with myasthenia gravis and a 57-year-old AB D-positive female lung transplant recipient. The haemoglobin decreased from 11·1 to 5·3 g dL-1 over 2 days, 12·8 to 7·8 g dL-1 over 6 days and 7·8 to 6·0 g dL-1 over several hours, respectively. All three patients had a negative antibody screen, positive direct antiglobulin test for IgG only and an elution containing anti-A1 reactivity. The patients were transfused with O RBC with an appropriate rise in haemoglobin. Conclusion: These cases illustrate the potential severity of haemolysis after IVIG because of passively transferred antibodies to blood group antigens. Lack of recognition of IVIG as a cause for haemolysis by clinicians may be further confounded if routine testing fails to detect the passively transferred ABO blood group antibodies.

Original languageEnglish (US)
Pages (from-to)267-270
Number of pages4
JournalTransfusion Medicine
Issue number4
StatePublished - Aug 1 2011


  • ABO blood group
  • Haemolysis
  • Intravenous immunoglobulin


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