Severe posttransfusion hyperhemolysis in a sickle cell patient produced profound anemia and lactic acidosis; terminal complement blockade with eculizumab stabilized hemolysis and enabled recovery.
Key Takeaways
A 26‑year‑old man with sickle cell disease (SCD) developed life‑threatening hyperhemolysis that progressed despite transfusion and high‑dose steroids, requiring intensive care and mechanical ventilation. The case supports a complement‑driven “bystander” destruction of both autologous and donor erythrocytes and documents clinical stabilization after terminal complement blockade with eculizumab. It highlights that when intravenous immunoglobulin and steroids fail, early consideration of complement inhibition together with rapid, multimodal supportive care is critical to improving chances of survival.