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| SPECIALIST ANSWERS
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Question |
12yr. male proved B-0 Thalassemia admitted for mod to severe abd.pain,fever of 102F and mild jaundice.Sonogram of Abd. revealed biliary sludge ,enlarged gullbladder and ofcourse significant splenohepatomegaly.Since Hb was 5G he received packed cell Transfusion alng with cefotaxime,amicacin and metronidazole.After the first Bl.Tr. he developed significant jaundice with Bil.of 30mg also cola coloured urine,BUN is normal.Considered now to have severe intravasc. hemolysis along with possible cholangitis. Request for comments. Thanks. DBD
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Answer |
Cola coloured urine is suggestive of intravascular hemolysis. BUN may be normal. Check the hemooglobin post transfusion (it would not have risen) and check the crossmatch of the blood bag given, was it of the same blood group? Do a DCT and haptoglobin levels. This is blood tranfusion reaction. Please read the article on "ADMINISTRATION OF BLOOD" on - www.pediatriconcall.com or from the link given below: -
http://www.pediatriconcall.com/AdministrationofBlood.html |
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