TY - JOUR T1 - Transfusion-related alloimmune neutropenia with no pulmonary complications: one donor-five cases. JF - Transfusion//Transfusion Y1 - 2016 A1 - Hauck-Dlimi, Barbara A1 - Ruppel, Renate A1 - Zimmermann, Robert A1 - Strobel, Julian A1 - Reil, Angelika A1 - Eckstein, Reinhold A1 - Zingsem, Juergen KW - *Isoantibodies/bl [Blood] KW - *Isoantigens/im [Immunology] KW - *Neutropenia/im [Immunology] KW - *Platelet Transfusion/ae [Adverse Effects] KW - *Transfusion Reaction/im [Immunology] KW - Adult KW - Aged KW - Biomarkers/bl [Blood] KW - Blood Donors KW - Female KW - Humans KW - Male KW - Middle Aged KW - Neutropenia/bl [Blood] KW - Neutropenia/di [Diagnosis] KW - Transfusion Reaction/bl [Blood] KW - Transfusion Reaction/di [Diagnosis] AB - BACKGROUND: Neutrophil alloantibodies are well-known triggers of transfusion-related acute lung injury (TRALI) and also cause immune neutropenia. Alloimmune neutropenia due to transfusion is an isolated phenomenon that is only rarely identified. Its incidence is specified in the literature as being less than one in 10,000 transfused plasma-containing units. We expect that this phenomenon is underreported., STUDY DESIGN AND METHODS: We observed five cases of alloimmune neutropenia with no respiratory complications with only one case initially reported as a suspected transfusion reaction. The other four cases were detected in the course of the subsequent lookback investigation., RESULTS: The first case was reported as a potential transfusion reaction when a female patient showed a decrease in the white blood cell count after a platelet (PLT) transfusion. Examinations of the donor blood revealed an antibody against the human neutrophil antigen HNA-1b; the recipient was typed HNA-1b positive and HNA-1a negative. After examining the blood counts of other patients who previously received PLT concentrates from the same donor, we identified four other patients with an unreported decrease in the leukocyte and/or granulocyte count of more than approximately 50% after transfusion., CONCLUSION: HNA antibodies are generally regarded as potential triggers of TRALI. Here we describe an HNA antibody that reproducibly caused transfusion-related neutropenia only without pulmonary complications. Factors predisposing patients to TRALI development are widely discussed. Our case suggests that antibody characteristics are also relevant in the development of TRALI. Current measures to prevent TRALI should also prevent transfusion-related alloimmune neutropenia.Copyright © 2015 AABB. M1 - wdn, 0417360 CY - United States VL - 56 SN - 1537-2995 CP - 1 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=26388439 ID - 4578 ER -