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Hemolytic Anemia Due to Anti‐A in Concentrated Antihemophilic Factor Preparations

Progressive anemia developed in a type A1 hemophiliac after he had received a large amount of commercial Factor VIII concentrate. Anti‐A was found in the patient's serum as well as in eluates from his erythrocytes. Moreover, the product contained potent anti‐A. A positive direct antiglobulin test and increased osmotic fragility with microspherocytosis were additional laboratory findings which suggested passive transfer of anti‐A as the cause of the anemia. The possibility of anemia due to transfused anti‐A or anti‐B should be considered in patients, other than those of type O, who manifest progressive anemia following treatment with large volumes of a pooled plasma product.