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
• passive transfer of immunoglobulin E antibodies to common environmental allergens
• anaphylatoxins or platelet biologic-response mediators generated during storage

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

More general terms

• blood transfusion reaction
• anaphylaxis