[Gastric neoplasm associated with IgA deficiency. Importance of multidisciplinary care].
We present the case of 55-year old female patient with a rare malignant disease of the stomach associated with IgA deficiency. For its management the surgical, transfusional and renal support strategy required good coordination of pre, intra and post-operative care, and good articulation among the various sub-specialties. The patient experienced two severe anaphylactoid transfunctional reactions. Congenital IgA deficiency was detected with probable anti-IgA immunization associated with a metacrone adenocarcinoma of the stomach and nephrotic syndrome with renal failure. The transfusion methods utilized are discussed, and the results of the study aimed at detecting a compatible donor, with identical deficit, among family members are presented. In the absence of a national registry of donors with IgA deficiency, the prevention of these potentially dangerous reactions imposes a burden on the Service of Immuno-Hematherapy to take special measures on its own. This case points out the need to implement a blood bank with rare groups and IgA deficient blood, for homo/autologous transfusions.
Branco
I
I
Serviço de Imuno-Hemoterapia, Hospital de Santa Maria, Lisboa.
da Costa
F B
FB
Rodrigues
A
A
Pires
F R
FR
Portugal
M A
MA
Gonçalves
M D
MD
D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000150:complications* / Q000235:genetics / Q000628:therapy; D008875:Middle Aged; D010348:Patient Care Team; D010375:Pedigree; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*
Neoplasia gástrica associada a défice de IgA. Importância da Multidisciplinaridade de Cuidados.