Blood transfusion reactions

Question 1

Clinical presenation: urticaria (raised hives), pruritus *(itchy skin), *wheezing, fever.

• What type of rxn is it?
• Pathogenesis
• Treatment

Answer 1

• What type of rxn is it? Allergic rxn
• Pathogenesis: Type I hypersensitivity rxn against plasma proteins in transfused blood
• Treatment: antihistamines

Question 2

**Clinical presentation: **Dyspnea *(shortness of breath), *bronchospasm, hypotension, respiratory arrest, shock

• What type of rxn is it?
• Pathogenesis

Answer 2

• Type of rxn: Anaphylatic rxn
• Pathogenesis:
  
  • severe allergic rxn.
  • IgA-deficient individuals must receive blood products that lack IgA.

Question 3

**Clinical presentation: **

Fever, hypotension, tachypnea, tachycardia, flank pain, hemoglobinemia *(intravascular), *jaundice (extravascular hemolysis)

• What type of rxn is it?
• Pathogenesis

Answer 3

• What type of rxn is it? Acute hemolytic transfusion rxn
• Pathogenesis
  
  • Type II hypersensitivity rxn
  • Intravascular hemolysis (ABO blood group incompatibility) or extravascualr hemolysis (host antibody rxn against foreign antigen on donor RBCs)

Question 4

Clinical presentation: Fever, headaches, chills, flushing

• What type of rxn is it?
• Pathogenesis

Answer 4

• What type of rxn is it? Febrile nonhemolytic transfusion reaction
• Pathogenesis:
  
  • Type II hypersensitivity rxn
  • host antibodies against donor HLA antigens and leukocytes.