{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:23:01Z","timestamp":1787844181457,"version":"build-2784847793"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:p>A 67-year-old male, presented with urosepsis, severe anemia, advancing azotemia requiring blood transfusion. Patient grouped as O RhD positive. Antibody screening was pan-positive (4+). Similar strong pan-positivity seen on antibody identification with extended cell panel. DAT was 4+ positive for IgG and negative for complement C3. Repeated identification with eluate also showed pan-positive (4+) reaction. Serum haptoglobin markedly reduced. Bone marrow aspirate suggested pure red cell aplasia with suspicion of parvovirus-related changes. Bone marrow biopsy suggested T-cell lymphoproliferative disorder. Immunophenotyping elucidated a suspicious clone of CD7-negative T-cells with CD4 restriction. Histopathological examination revealed angioimmunoblastic T-cell lymphoma (AITL) with bystander Epstein\u2013Barr virus-driven large B-cells. Owing to rarity and nonspecific symptoms, diagnosis of AITL is often challenging. Antibody screen acted as a whistleblower for an undiagnosed aggressive lymphoma. Thus, it will be prudent to look beyond the obvious in complex cases, and a detailed workup will help put together all parts of the jigsaw puzzle.<\/jats:p>","DOI":"10.4103\/ajts.ajts_122_24","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T04:00:10Z","timestamp":1737691210000},"page":"203-207","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A whistleblower direct antiglobulin test in chronic kidney disease: An interesting case of occult autoimmune hemolytic anemia in an undiagnosed lymphoma with pure red cell aplasia"],"prefix":"10.4103","volume":"20","author":[{"given":"Rasika Dhawan","family":"Setia","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine, BLK-Max Super Specialty Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitu","family":"Dogra","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, BLK-Max Super Specialty Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Laboratory Services, BLK-Max Super Specialty Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"R2-20260529","doi-asserted-by":"crossref","first-page":"642296","DOI":"10.3389\/fmed.2021.642296","article-title":"Anemia in chronic kidney disease:From pathophysiology and current treatments, to future agents","volume":"8","author":"Portol\u00e9s","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"R3-20260529","doi-asserted-by":"crossref","first-page":"25","DOI":"10.15171\/jnp.2017.05","article-title":"Pure red cell aplasia due to antibody against erythropoietin in hemodialysis patients","volume":"6","author":"Rahbar","year":"2017","journal-title":"J Nephropathol"},{"key":"R4-20260529","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/0022-3859.109495","article-title":"Pure red cell aplasia following autoimmune hemolytic anemia:An enigma","volume":"59","author":"Saha","year":"2013","journal-title":"J Postgrad Med"},{"key":"R6-20260529","doi-asserted-by":"crossref","first-page":"e19015","DOI":"10.1097\/MD.0000000000019015","article-title":"Clinical analysis of 20 patients with non-Hodgkin lymphoma and autoimmune hemolytic anemia:A retrospective study","volume":"99","author":"Zhou","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"R7-20260529","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/MD.0b013e3181573059","article-title":"Angioimmunoblastic T-cell lymphoma:Clinical and laboratory features at diagnosis in 77 patients","volume":"86","author":"Lachenal","year":"2007","journal-title":"Medicine (Baltimore)"},{"key":"R8-20260529","doi-asserted-by":"crossref","first-page":"405","DOI":"10.5306\/wjco.v11.i6.405","article-title":"Angioimmunoblastic T-cell lymphoma accompanied by pure red cell aplasia:A case report","volume":"11","author":"Kawahigashi","year":"2020","journal-title":"World J Clin Oncol"}],"container-title":["Asian Journal of Transfusion Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ajts.ajts_122_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:12:48Z","timestamp":1787843568000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ajts.ajts_122_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ajts.ajts_122_24","relation":{},"ISSN":["0973-6247","1998-3565"],"issn-type":[{"value":"0973-6247","type":"print"},{"value":"1998-3565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]},"assertion":[{"value":"2024-07-16","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}