Life-Threatening Pancreatitis in Jehovah’s Witness Patients With Severe Anemia Treated Without Transfusions and by Interventional Radiology Techniques

2018 ◽  
Vol 34 (2) ◽  
pp. 165-170
Author(s):  
Patrick Kishi ◽  
Eric vanSonnenberg ◽  
Misa Stroker
Keyword(s):  
Interventional Radiology ◽  
Blood Product ◽  
Wide Spectrum ◽  
Blood Transfusions ◽  
Severe Anemia ◽  
Medical Specialties ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Life Saving ◽  
Life Threatening

Blood transfusions in anemic patients frequently are used for critically ill patients as a life-saving therapeutic maneuver. Jehovah’s Witness (JW) patients typically refuse blood transfusions due to religious beliefs. Numerous clinical reports, in a wide spectrum of medical specialties, have shown no greater morbidity or mortality in JW patients or others who refused transfusions compared to those patients who accept transfusions. We report our experience with two JW patients who presented with severe anemia and life-threatening pancreatitis. Despite undergoing percutaneous drainages by interventional radiology (IR) for complex pancreatic collections (and other IR drainages), neither patient suffered any adverse effect from the IR procedures, even though they refused blood transfusions. Our experience suggests that IR procedures also may be successful with this more limited blood product protocol.

Severe anemia in the Jehovah's Witness: case report and discussion

1993 ◽  
Vol 2 (3) ◽  
pp. 256-259 ◽  
Author(s):  
SL Collins ◽  
GA Timberlake
Keyword(s):  
Case Report ◽  
Blood Loss ◽  
Severe Anemia ◽  
Blood Products ◽  
Jehovah’S Witness ◽  
Airplane Crash ◽  
Jehovah's Witness ◽  
Life Threatening

Major blood loss following trauma is common, but severe anemia is generally not life-threatening when managed with the administration of blood and blood products. Severe anemia becomes particularly challenging and potentially lethal when the patient is a Jehovah's Witness, for whom receiving a transfusion is contrary to religious principles. This case report describes the management and hospital course of a Jehovah's Witness who was seriously injured in an airplane crash.

scholarly journals Jehovah’s Witness survives severe favism complications: Advance provisions of treatment and new challenges for the physicians

2021 ◽  
Vol 17 (2) ◽  
Author(s):  
Massimo Salvetti ◽  
Sara Capellini ◽  
Paola Delbon ◽  
Francesca Maghin ◽  
Maria Lorenza Muiesan ◽  
...  
Keyword(s):  
Multiorgan Failure ◽  
Legal Aspects ◽  
Severe Anemia ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Risk Of Death ◽  
Vital Functions ◽  
Life Threatening ◽  
Main Components ◽  
Adequate Tissue

The management of an acute hemolytic event in a patient suffering from favism is based on transfusion support to ensure adequate tissue oxygenation. If this measure could not be pursued, in case of severe anemia the risk of death from multiorgan failure would be relevant. Most of Jehovah’s Witness decline transfusion of whole blood and its main components, even in life-threatening situations. In this context, the treatment of severe anemia in these patients still represents a challenge from both medical and legal stand points. Authors report a case of a Jehovah’s Witness suffering from favism who refused blood transfusion, surviving a severe event of critical anemia associated with acute renal failure, thanks to the application of alternative therapies. It is essential that clinicians know the medico-legal aspects in such situations and are able to act promptly to support the patient’s vital functions, by complying with his/her wishes.

Recovery From Hemoglobin Of 2g/Dl Without Prbc Transfusion: A Lesson Learned From a Jehovah’s Witness With Cold Agglutinin Disease

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4657-4657
Author(s):  
Pouyan Gohari ◽  
Abhinav B. Chandra ◽  
Richard Slatkin ◽  
Jay S. Lipshitz
Keyword(s):  
Blood Product ◽  
Conflicts Of Interest ◽  
Cold Agglutinin ◽  
Red Blood Cell Transfusion ◽  
Blood Product Transfusion ◽  
Cold Agglutinin Disease ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Life Threatening ◽  
Supportive Management

Supportive management of critically ill patients with anemia often involves packed red blood cell transfusion. Jehovah’s Witness’ refusal of blood products because of their religious beliefs can render these situations challenging. Successful adaptation of medical management in Jehovah’s Witness’ with severe anemia provides physicians with a distinct opportunity to question common transfusion practices and learn about anemia. We present a case of a 43 year-old Jehovahs Witness who presented with autoimmune hemolytic anemia – cold agglutinin disease. His hemoglobin nadired at 2g/dL. The patient was successfully managed to recovery with corticosteroids, rituximab, folic acid and an erythropoeitin stimulating agent. To our knowledge this is the lowest Hgb that a patient with life threatening cold agglutinin disease survived without the use of any blood product transfusion. Such cases afford a deeper appreciation of the body's ability to adapt to and recover from anemia without the use of exogenous blood. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Successful treatment of total placenta previa by multidisciplinary therapy in a Jehovah’s Witness patient who refused blood transfusions

2018 ◽  
pp. bcr-2018-226486
Author(s):  
Sayaka Tachi ◽  
Noriko Yoneda ◽  
Satoshi Yoneda ◽  
Shigeru Saito
Keyword(s):  
Placenta Previa ◽  
Blood Transfusions ◽  
Multidisciplinary Therapy ◽  
Jehovah’S Witness ◽  
Blood Salvage ◽  
Jehovah's Witness ◽  
Balloon Catheters ◽  
Acute Normovolaemic Haemodilution ◽  
Witness Patient ◽  
Intraoperative Blood Salvage

A 35-year-old Jehovah’s Witness patient with total placenta previa was referred to our hospital at 30 weeks of gestation. She refused autologous and allogeneic blood transfusions, but agreed to receive acute normovolaemic haemodilution, intraoperative blood salvage and biological products. At 35 weeks, she underwent emergent caesarean delivery because of labour pains. Multidisciplinary therapy, including the insertion of balloon catheters into the bilateral common iliac arteries, acute normovolaemic haemodilution and intraoperative blood salvage, avoided hysterectomy; however, blood loss included amniotic fluid which was estimated to be 1910 mL. These treatments may be effective for total placenta previa in blood-refusal patients.

scholarly journals El paciente testigo de Jehová : la negativa al tratamiento médico en situación de gravedad y la circular 1/2012 de la Fiscalía General del Estado

2012 ◽  
Author(s):  
José Ramón Díez Rodríguez
Keyword(s):  
Pregnant Woman ◽  
Medical Treatment ◽  
Patient Autonomy ◽  
Blood Transfusions ◽  
Health Law ◽  
Medical Treatments ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Para Determinar ◽  
Witness Patient

El paciente testigo de Jehová y su rechazo a determinados tratamientos médicos, en concreto a las transfusiones de sangre, constituye uno de los problemas fundamentales con el que históricamente se ha tenido que enfrentar el derecho sanitario. La actual Ley 41/2002 de autonomía del paciente parece dejar claro el supuesto del paciente mayor de edad y la posibilidad de rechazar tratamientos médicos, pero mayores problemas plantean los supuestos del menor de edad, y especialmente la figura del menor maduro, y el supuesto de la mujer embarazada testigo de Jehová. Será necesario atender a la proporcionalidad de derechos en conflicto para determinar los criterios que en cada caso nos permitan inclinar la balanza a favor de una u otra posición.The Jehovah’s Witness patient and their rejection of certain medical treatments, namely blood transfusions, is one of the fundamental problems with which historically had to face the health law. The current Law 41/2002 of patient autonomy seems to clarify the adult patient’s adult and their possibility of refusing medical treatment, but major problems posed minor assumptions, especially the mature minor figure, and the course pregnant woman Jehovah’s Witness. It will be necessary to address the proportionality of conflicting rights, and determining criteria in each case allow us to tip the balance in favor of one position or another.

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