Bad Blood

  • Mark T. Friedman
  • Kamille A. West
  • Peyman Bizargity
  • Kyle Annen
  • Jeffrey S. Jhang


A 48-year-old man with a history of pancreatic cancer who underwent distal pancreatectomy and splenectomy 4 months ago presents with fatigue, weakness, pallor, and dyspnea on exertion. On hospital admission, the patient is found to be severely anemic with a hemoglobin (Hgb) of 5.6 g/dL and a lactate dehydrogenase (LDH) level of 1180 U/L, total bilirubin level of 6.4 mg/dL, haptoglobin level less than 7 mg/dL, and a reticulocyte count of 16.2%. The blood bank history shows that the patient had received two units of red blood cells (RBCs) post pancreatectomy (one on postoperative day #1 and the second on postoperative day #2); the preoperative antibody screen was negative. A type and screen (ethylenediaminetetraacetic acid [EDTA] anticoagulant) sample is submitted to the blood bank along with a request for crossmatch of two units of RBCs for transfusion.


Babesia microti Babesiosis Exchange transfusion Malaria Plasmodium falciparum 


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Recommended Reading

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mark T. Friedman
    • 1
  • Kamille A. West
    • 2
  • Peyman Bizargity
    • 3
  • Kyle Annen
    • 4
  • Jeffrey S. Jhang
    • 1
  1. 1.Icahn School of MedicineMount Sinai Health SystemNew YorkUSA
  2. 2.Department of Transfusion MedicineNational Institutes of Health Clinical CenterBethesdaUSA
  3. 3.Department of Molecular & Human GeneticsBaylor College of MedicineHoustonUSA
  4. 4.Department of PathologyChildren’s Hospital ColoradoAuroraUSA

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