Immunologic Blood Transfusion Reactions

Question 1

anaphylactic onset

Answer 1

within seconds to minutes

Question 2

anaphylactic cause

Answer 2

recipient anti-IgA antibodies directed against donor blood IgA

Question 3

anaphylactic key features

Answer 3

angioedema, hypotension, respiratory distress/wheezing, shock
IgA deficient recipient

Question 4

acute hemolytic onset

Answer 4

within 1hr

Question 5

acute hemolytic cause

Answer 5

ABO incompatibility (often clerical error)

Question 6

acute hemolytic features

Answer 6

fever, flank pain, hemoglobinuria
DIC
positive Coombs

Question 7

febrile nonhemolytic onset

Answer 7

within 1-6hr

Question 8

febrile nonhemolytic cause

Answer 8

cytokine accumulation during blood storage

Question 9

febrile nonhemolytic features

Answer 9

fever and chills

Question 10

urticarial onset

Answer 10

within 2-3hr

Question 11

urticarial cause

Answer 11

recipient IgE against blood product component

Question 12

urticarial features

Answer 12

urticaria

Question 13

transfusion-related acute lung injury onset

Answer 13

within 6hr

Question 14

transfusion-related acute lung injury cause

Answer 14

donor anti-leukocyte antibodies

Question 15

transfusion-related acute lung injury features

Answer 15

respiratory distress

noncardiogenic pulmonary edema with bilateral pulmonary infiltrates

Question 16

delayed hemolytic onset

Answer 16

within days to weeks

Question 17

delayed hemolytic cause

Answer 17

anamnestic antibody response

Question 18

delayed hemolytic features

Answer 18

often asymptomatic
laboratory evidence of hemolytic anemia
positive Coombs test, positive new antibody screen

Question 19

graft vs host onset

Answer 19

within weeks

Question 20

graft vs host cause

Answer 20

donor T-lymphocytes

Question 21

graft vs host features

Answer 21

rash, fever, gastrointestinal symptoms, pancytopenia