Introduction: Acute hemolytic transfusion reaction is a rare but extremely mortal condition. Even small quantities of ABO-incompatible erythrocytes, as much as 50 mL, can lead to fatality. Since there is no successful standard therapy, preventive measures are very important. In this case report, we presented a 29-year-old woman who was transfused with 2 units of AB Rh-positive instead of 0 Rh-positive red blood cells following a cesarean section. As far as we know, this is the first patient in the literature for whom ruxolitinib was used as a part of therapy. Case Report: The patient was referred to our center 22 h after the ABO-mismatched transfusion. On admission, she had severe hemolysis, acute renal failure, and disseminated intravascular coagulation. Massive plasma exchange, hemodialysis, and pulse steroid therapy were commenced. The patient was refractory to first-line therapies. She was intubated on day 2 due to hypoxia, respiratory failure and changes in consciousness. Ruxolitinib, 2 × 10 mg/day, was started on day 3. The patient’s clinical status improved on day 6. Ruxolitinib was withdrawn on day 15, and the patient was discharged without any complications or sequels on day 26. Conclusion: Ruxolitinib may be life-saving in patients with ABO-incompatible transfusion reaction which follows a severe and catastrophic course.
Transfus Med Hemother

中文翻译：

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鲁索替尼联合血浆置换治疗严重急性溶血性输血反应

简介：急性溶血性输血反应是一种罕见但极其致命的疾病。即使是少量的 ABO 不相容红细胞，多达 50 毫升，也可能导致死亡。由于没有成功的标准疗法，因此预防措施非常重要。在本病例报告中，我们介绍了一名 29 岁女性，她在剖宫产术后输注了 2 个单位的 AB Rh 阳性红细胞而不是 0 个 Rh 阳性红细胞。据我们所知，这是文献中第一个使用鲁索替尼作为治疗一部分的患者。案例报告：在 ABO 不匹配输血后 22 小时，患者被转诊至我们的中心。入院时，她出现严重溶血、急性肾功能衰竭和弥散性血管内凝血。开始大量血浆置换、血液透析和脉冲类固醇治疗。患者对一线治疗无效。由于缺氧、呼吸衰竭和意识改变，她在第 2 天被插管。鲁索替尼 2×10mg/天，第 3 天开始，第 6 天患者临床状况好转，第 15 天停用鲁索替尼，第 26 天患者无任何并发症或后遗症出院。在严重和灾难性的过程中发生 ABO 血型不相容的输血反应的患者可以挽救生命。
Transfus Med Hemother