T-cryptantigen (TCA) activation in sever pneumonia complicated with multiple organ failure

A 19-month-old boy presented RBC T-cryptantigen (TCA) activation with severe pneumonia complicated with abnormal coagulation. The boy received fresh frozen plasma before TCA activation was confirmed. He developed hemolysis and multiple organ failure. The hemolysis anemia was successfully treated with washed RBC transfusion. However, he had to use dialysis because of renal dysfunction. The case prompted an urgent call to screen RBC TCA-activation in selective pediatric patients.