PMC9246625_01
Onset of severe immune hemolysis and autoimmune thyroiditis in a HSCT recipient. (a): Hemoglobin level and timeline of red blood cell (RBC) transfusions up to day +12 after HSCT. Note that a severe hemolytic transfusion reaction occurred after transfusion of group A iRBCs on day +10, which prompted an emergent red blood cell exchange. (b): Free-T4 (fT4) and (c) thyroid-stimulating hormone (TSH) levels up to day +2500 post-HSCT. Note the appearance of antithyroglobulin (Anti-TG) in the serum followed by the peak of TSH and the drop of fT4, indicating autoimmune thyroiditis.
CRII2022-1690489.001.jpg
PMC9246625_01_CRII2022-1690489.001.jpg
fig1
He was transfused one unit of irradiated iRBCs on each of day +3, +5, +7, +8, and +10 (Figure 1(a)). HT in the donor, the patient was monitored with serum free-T4 (fT4) levels (Figure 1(b)), thyroid-stimulating hormone (TSH) (Figure 1(c)) and the presence of autoantibodies directed against the thyroid. His thyroid panel pretransplant was normal, including the absence of detectable antibodies. However, the patient was not compliant with his thyroid hormone replacement therapy for a long period during which fT4 level was low and TSH was high (Figures 1(b) and 1(c)).