{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:52:29Z","timestamp":1773049949907,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,5,6]],"date-time":"2018-05-06T00:00:00Z","timestamp":1525564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The therapeutic value of the use of intravenous immunoglobulin (IVIG) to correct anemia and thrombocytopenia as a result of immunologic causes (hemolytic disease of the fetus and newborn and fetal or neonatal alloimmune thrombocytopenia) have been well established. Few published papers exist regarding the use of IVIG in adult settings. We report two patients with clinically significant antibodies against high\u2010incidence antigens, who were successfully transfused with incompatible red blood cells (RBCs), in conjunction with IVIG plus steroids and IVIG.<\/jats:p><\/jats:sec><jats:sec><jats:title>CASE REPORTS<\/jats:title><jats:p>Case 1 was a 25\u2010year\u2010old patient (Hb SC) who was admitted with low hemoglobin (Hb) and low reticulocyte count. A diagnosis of parvovirus\u2010induced RBC hypoplasia was made. The patient's sample contained anti\u2010E, anti\u2010N, and anti\u2010U. The Hb decreased to 37 g\/dL and urgent transfusion was provided with E\u2013, N\u2013, \u201cleast\u2010incompatible\u201d RBC units covered by IVIG and hydrocortisone. Case 2 was a 54\u2010year\u2010old patient who was admitted after a road traffic accident. Nonspecific weak antibody was detected. She received 6 units of least\u2010incompatible RBCs. She was transferred to another hospital and received 2 least\u2010incompatible units. Hb level decreased further and an additional unit was transfused. Samples were referred to the reference laboratory and strong anti\u2010Jr<jats:sup>a<\/jats:sup> detected. As there was clinical and laboratory evidence of hemolysis and Jr(a\u2013) units were not available, IVIG was prescribed and least\u2010incompatible units were transfused.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>There were no hemolytic transfusion reactions, hemolysis ceased, and anemia improved in both cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Prophylaxis with IVIG plus steroids and IVIG should be considered as a therapeutic option when transfusion of incompatible units is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14648","type":"journal-article","created":{"date-parts":[[2018,5,7]],"date-time":"2018-05-07T05:04:54Z","timestamp":1525669494000},"page":"1626-1630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Transfusions of least\u2010incompatible blood with intravenous immunoglobulin plus steroids cover in two patients with rare antibody"],"prefix":"10.1111","volume":"58","author":[{"given":"Nay","family":"Win","sequence":"first","affiliation":[{"name":"Department of Red Cell Immunohaematology National Blood Service\u2013Tooting Center Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm","family":"Needs","sequence":"additional","affiliation":[{"name":"Department of Red Cell Immunohaematology National Blood Service\u2013Tooting Center Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Thornton","sequence":"additional","affiliation":[{"name":"International Blood Group Reference Laboratory Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Webster","sequence":"additional","affiliation":[{"name":"Department of Red Cell Immunohaematology NHS Blood and Transplant (Sheffield Centre) Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cherry","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Haematology Nottingham City Hospital Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1990.tb02060.x"},{"key":"e_1_2_6_3_1","first-page":"256","article-title":"Less common antigen systems","author":"Mollison PL","year":"1993","journal-title":"Blood Transfus Clin Med"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1953.02940330028010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10013.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.00643.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-400"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1976.16677060250.x"},{"key":"e_1_2_6_9_1","first-page":"49","article-title":"Transfusion reaction due to anti\u2010Jra [abstract]","volume":"4","author":"Jowitt S","year":"1994","journal-title":"Transfus Med"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01787.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2007.01.001"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118493595.ch27"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-7963(90)70265-9"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198811243192103"},{"key":"e_1_2_6_15_1","first-page":"67","article-title":"Antenatal treatment of alloimmune thrombocytopenia","volume":"80","author":"Lynch L","year":"1992","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1991.tb00944.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1997.8762507.x"},{"key":"e_1_2_6_18_1","unstructured":"Department of Health and Social Care.Clinical guidelines for immunoglobulin use: second edition update [Internet].London:UK.GOV;2011[cited 2018 Apr 16]. 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