Transfusion-associated anaphylactoid reactions associated with anti-IgA

Status:

Ready to upload

Record number:

1970

Adverse Occurrence type:

Allergic Reaction

MPHO Type:

Red blood cells

Estimated frequency:

Rare

Time to detection:

Minutes

Alerting signals, symptoms, evidence of occurrence:

Unusual presentation of rigors, hypertension, transient monocytopenia,and neutropenia after receiving red cell transfusion.

Demonstration of imputability or root cause:

Patient was found to be deficient in IgA (<0.05 mg/dL). Very high levels of anti-IgA of IgG class antibodies detected by enzyme-linked immunosorbent assay (>1000 U/mL). No symptoms after receiving washed red cell products.

Imputability grade:

2 Probable

Groups audience:

Clinical complications

Keywords:

RBC (red blood cell)

allergic reaction

ATR (allergic transfusion reaction)

References:

Neutropenia and monocytopenia in recurrent anaphylactoid reactions after red blood cell transfusions in a woman with immunoglobulin A (IgA) deficiency and anti-IgA

Reference attachment:

transfusion-associated anaphylactoid reactions, Warkentin, 2018.pdf

Suggest references:

Neutropenia and monocytopenia in recurrent anaphylactoid reactions after red blood cell transfusions in a woman with immunoglobulin A (IgA) deficiency and anti-IgA. Transfusion. 2018 Oct;58(10):2320-2325

Expert comments for publication:

Unusual reaction to 2 RBC units in the same patient who is IgA deficient with very high levels of anti-IgA antibodies. Symptoms like dyspnea, substernal pain, laryngeal edema and circulatory collapse that have been described in transfusion medicine test books and literature to be associated with anti-IgA reactions were not seen in this patient. However, the patient presented with anaphylactoid features such as rigors and hypertension, with transient monocytopenia and neutropenia.