A 68-year-old woman, whose only relevant history was iron deficiency anemia studied by Gastroenterology since May 2013, with no history of nephrology.
After anemization (haemoglobin 6.5g/dl), the patient was referred to a hospital for transfusion of concentrated glycated urea, progressive post-transfusion reactions, and progressive deterioration of renal function, 171mg/creatinine levels.
It was decided to be admitted to the Nephrology Department, where a complete study was conducted and hemoglobin values up to 4.2mg/dl, LDH of 997UI/l, indirect bilirubin of 1.19% and blood smears of 36mg/dl with granulocytes were observed.
Hematuria and pyuria were observed in urine reactive strip.
The data suggested intravascular hemolytic anemia of autoimmune origin due to blood incompatibility.
The Hematology Service was consulted and reported the presence of irregular antibodies with anti-Tja specificity of 1/16.
These results are consistent with the absence of a high incidence antigen in the general population, the P antigen. During admission renal function improved.
She required several hemodialysis sessions, supportive treatment with intense serum therapy and alkalinization, and treatment for her anemia with erythropoietin and intravenous iron, transfusion of four hemodialysis concentrates.
Currently it has a creatinine of 0.3mg/dl and a hemoglobin of 10.6g/dl.
