Hemolytic and pseudo-hemolytic transfusion reactions: an overview of the hemolytic transfusion reactions and the clinical conditions that mimic them.

Abstract

When a reaction occurs during or after the transfusion of a blood product, those in­ volved in the care of that patient tend to think first of an immunological evenl. l However, many transfusion reactions may not be immunologically mediated. The differential diagnosis of a transfu­ sion reaction should include the many nonimmune conditions that can lead to the destruction of either donor or recipient's red blood cells. In addition, such reactions may only simulate some of the many manifestations of hemolytic transfusion re­ actions. Events simulating hemolytic transfusion reactions have been termed by some investigators as pseudo-hemolytic transfusion reactions. ,,2,3 In this artiele, the postulated mechanisms of he­ molytic transfusion reactions are reviewed and compared with the immediate and delayed reac­ tions that can mimic them (TabIe l).