Acute transient leukopenia as a sign of TRALI

Marques, Marisa B.; Tuncer, Hande H.; Divers, Stephen G.; Baker, Allyson C.; Harrison, D. Keith

doi:10.1002/ajh.20378

Cited by 92 publications

(6 citation statements)

References 5 publications

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“…Our patient became leucocytopenic after one of the transfusion reactions. Transient leucopenia has been associated with other cases of TRALI and leucocyte antibody-mediated transfusion reactions [1,[10][11][12][13][14]. Measuring a white blood count following a transfusion reaction may be helpful in investigating a suspected TRALI reaction.…”

Section: Discussionmentioning

confidence: 99%

Patient‐specific transfusion‐related acute lung injury

Muniz¹,

Sheldon²,

Schuller³

et al. 2007

Vox Sanguinis

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Transfusion-related acute lung injury (TRALI) is one of the leading causes of transfusion-associated mortality. The inadvertent transfusion of neutrophil antibodies can cause pulmonary transfusion reactions and TRALI. However, not all patients transfused with neutrophil antibodies experience transfusion reactions. A 22-year-old man with severe aplastic anaemia (SAA) experienced TRALI after a platelet transfusion. The donor was found to be alloimmunized to human neutrophil antigen (HNA)-3a, an antigen expressed by neutrophils from approximately 90% of Caucasians. Eleven other platelet components from this donor were transfused prior to this event and two caused reactions: one chills and one TRALI. Both episodes of TRALI occurred in the same male patient with SAA. The fact that one patient experienced TRALI following both exposures to anti-HNA-3a from the same donor whereas nine other recipients did not adds evidence to the observation that patient factors make a significant contribution to neutrophil antibody-mediated transfusion reactions.

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Section: Discussionmentioning

confidence: 99%

Patient‐specific transfusion‐related acute lung injury

Muniz¹,

Sheldon²,

Schuller³

et al. 2007

Vox Sanguinis

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“…It has been known for almost 50 years that the transfusion of white blood cell (WBC) antibodies can cause pulmonary reactions 2 and some, but not all, cases of TRALI involve the transfusion of WBC antibodies. In some cases of TRALI when WBC antibodies have been implicated, the transfusion reaction has been associated with transient leukopenia 3‐6 …”

mentioning

confidence: 99%

The transfusion of neutrophil‐specific antibodies causes leukopenia and a broad spectrum of pulmonary reactions

et al. 2007

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“…Presence of incompatible antibodies however, does not necessitate the clinical syndrome of TRALI 3. Additionally, a transient leucopenia, varying from an 8% to a 30% drop in the leucocyte count, is a highly specific occurrence 4. However, in the acute situation, none of these laboratory tests are useful for influencing clinical management as patients often escalate to requiring intubation within hours of onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

A prophylactic fresh frozen plasma transfusion leads to a possible case of transfusion-related acute lung injury

et al. 2014

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A 39-year-old man with cholangiocarcinoma presented with fever and abdominal pain. He was hypotensive, jaundiced and had right upper quadrant tenderness. Laboratory testing showed a leucocytosis, elevated liver function tests, total bilirubin and International Normalised Ratio (INR). Given the concern for cholangitis, the patient was given antibiotics and three units of fresh frozen plasma (FFP) before biliary drain placement. After drain placement, and within 3 h of receiving blood products, the patient became tachypnoeic and hypoxic with a chest X-ray revealing new bilateral airspace disease. The rapid development of respiratory distress was determined to most likely be transfusion-related acute lung injury (TRALI). He rapidly progressed to intubation and required 100% FiO2, high positive-end expiratory pressure (PEEP) and intermittent-prone ventilation for 48 h but eventually recovered and was extubated. TRALI is an under-recognised aetiology for respiratory distress in the critically ill. Adopting a conservative transfusion strategy may prevent TRALI.

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Acute transient leukopenia as a sign of TRALI

Cited by 92 publications

References 5 publications

Patient‐specific transfusion‐related acute lung injury

Patient‐specific transfusion‐related acute lung injury

The transfusion of neutrophil‐specific antibodies causes leukopenia and a broad spectrum of pulmonary reactions

A prophylactic fresh frozen plasma transfusion leads to a possible case of transfusion-related acute lung injury

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