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anaphylactic transfusion reaction

Etiology: - IgA deficient recipient with anti-IgG Ab - direct infusion of allergens (donor-ingested foods, medications) - polymorphic forms of serum proteins (IgA, haptoglobin, complement C3 complement C4, transferrin, albumin, others) to which the patient has been presensitized [2] - passive transfer of immunoglobulin E antibodies to common environmental allergens - anaphylatoxins or platelet biologic-response mediators generated during storage [2] Epidemiology: - 1.7-4.3 per 100,000 packed RBC & plasma transfusions - 62.6 per 100,000 platelet pools Pathology: - anti-IgA antibodies in IgA-deficient individuals Clinical manifestations: - sudden hypotension, hypoxemia, respiratory distress, stridor during transfusion Management: - stop transfusion - see anaphylaxis Prevention: - use of washed RBC in IgA-deficient patients - use of blood components from IgA-deficient donors, especially plasma products

General

blood transfusion reaction anaphylaxis

References

  1. Sandler SG, Vassallo RR. Anaphylactic transfusion reactions. Transfusion. 2011 Nov;51(11):2265-6. PMID: 22023182
  2. NEJM Knowledge+. Question of the Week. Dec 13, 2016 http://knowledgeplus.nejm.org/question-of-week/1132/