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Williams LA, Adamski J, Kinard TN, Ertz-Archambault NM, Lu Q, Gray K, Herrick JL, Su L, Padrnos L. The first reported use of red blood cell exchange to treat hemoglobin Evans with secondary methemoglobinemia. J Clin Apher 2023; 38:755-759. [PMID: 37665037 DOI: 10.1002/jca.22086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/31/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
This manuscript describes a novel approach for treating patients with long-term sequelae from hemoglobin Evans (Hb Evans). After instituting conservative therapies for approximately 2 years, our patient's symptoms continually worsened. Therefore, we performed red blood cell exchange (RBCx) to reduce his Hb Evans percentage and his co-existing elevation of methemoglobin. Our assumptions of clinical benefit were based on our collective experience performing RBCx for patients with sickle cell disease. After the first exchange, pre- and post-laboratory results supported our approach and the patient experienced marked improvement in his clinical signs and symptoms. This report provides preliminary proof of principle for the use of RBCx to treat Hb Evans and other non-Hb S hemoglobinopathies.
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Affiliation(s)
- Lance A Williams
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Jill Adamski
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Theresa N Kinard
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | | | - Qun Lu
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Kristin Gray
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Jennifer L Herrick
- Department of Laboratory Medicine and Pathology (Hematopathology), Mayo Clinic, Rochester, Minnesota, USA
| | - Leon Su
- Department of Laboratory Medicine and Pathology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Leslie Padrnos
- Department of Hematology/Oncology, Mayo Clinic Hospital, Phoenix, Arizona, USA
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Hayakawa I, Hataya H, Kaneko T. Choledocholithiases in a child with Hemoglobin Evans [alpha2 62(E11) Val→Met]. Clin Case Rep 2016; 4:661-3. [PMID: 27386123 PMCID: PMC4929800 DOI: 10.1002/ccr3.588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/12/2016] [Accepted: 04/30/2016] [Indexed: 11/18/2022] Open
Abstract
We present the first description of choledocholithiases in a 10‐year‐old boy with Hemoglobin Evans. Although biliary stones are much less common in children than in adults, epigastric pain in children with known hemolytic status should alert the physician to the possibility of biliary colic.
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Affiliation(s)
- Itaru Hayakawa
- Department of General Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan
| | - Hiroshi Hataya
- Department of General Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan
| | - Takashi Kaneko
- Department of Hematology and Oncology Tokyo Metropolitan Children's Medical Center Tokyo Japan
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