Pediatric Hematology and Oncology, 24:269–273, 2007 Copyright C  Informa Healthcare ISSN: 0888-0018 print / 1521-0669 online DOI: 10.1080/08880010701360650 Case Report HEMOPURE TRANSFUSION IN A CHILD WITH SEVERE ANEMIA D. C. Stefan, R. Uys, and G. Wessels ✷ Tygerberg Children’s Hospital, Paediatrics and Child Health, Tygerberg, Western Cape Province, South Africa ✷ A 23-month-old girl presented with heart failure from extremely severe sickle cell anemia. The family refused blood transfusion on religious grounds (Jehovah’s Witness). Alternative options acceptable to this religion, such as iron, erythropoietin, or folic acid were rejected as useless in the particular situation of the child. The patient was transfused with Hemopure, a product that consists of polymerized bovine hemoglobin. This is the first case reported in the literature of a child transfused, in an emergency situation, with this product. Keywords Hemopure, red cell substitutes, sickle cell anemia, acute heart failure, Jehovah’s Witness CASE REPORT A 23-month-old girl was brought by her parents with a short history of vomiting, refusing to eat, and becoming increasingly short of breath. Her family emigrated recently from the Republic of Congo. Several close relatives, including some of her siblings, were already known to have sickle cell anemia. The birth history of this patient was unremarkable and she had not been diagnosed with sickle cell disease before. Immunizations were on schedule and anthropometry, as well as developmental milestones, were age appropriate. Clinical examination revealed an extremely pale and acutely ill child. Her respiratory rate was 66/min, heart rate 170 beats/min, blood pressure 70/35 mm Hg, and her temperature was normal. Her skin turgor was normal, while the dry tongue and slightly sunken eyes suggested a mild dehydration. The oxygen saturation of the child was 90% in room air. The child was tachypneic, with intercostal recession and nasal flaring. An examination of the cardiovascular system revealed an ejection systolic murmur of 3/6 intensity and the presence of a gallop rhythm. The spleen Received 21 November 2006; accepted 22 March 2007. Address correspondence to D. C. Stefan, Department of Pediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children’s Hospital, P.O. Box 19063, Tygerberg 7505, Cape Town, South Africa. E-mail: cs@sun.ac.za 269 Pediatr Hematol Oncol Downloaded from informahealthcare.com by CDL-UC Davis on 10/26/14 For personal use only.