Transfusion-related acute lung injury following intravenous anti-D administration in an adolescent.
Transfusion-related acute lung injury (TRALI) is associated with administration of all plasma containing blood products. We present a 14-year-old adolescent diagnosed with idiopathic thrombocytopenic purpura who developed acute respiratory insufficiency compatible with TRALI within 5 hr following intravenous anti-D. Full blown noncardiogenic pulmonary edema was noted after 9 hr. Mechanical ventilation was not required and the patient made a full recovery after 36 hr. Analysis of the anti-D preparation revealed reactivity against the neutrophil FcgammaRIIIb. A postinfusion serum sample contained antibodies against class I human HLA-A11 antigen. Clinicians should consider TRALI in patients developing unexplained dyspnea after receiving intravenous anti-D.
Berger-Achituv
Sivan
S
Department of Pediatrics, Meir Medical Center, Kfar Saba, Israel.
Ellis
Martin H
MH
Curtis
Brian R
BR
Wolach
Baruch
B
D000293:Adolescent; D015234:HLA-A Antigens / Q000276:immunology; D059870:HLA-A11 Antigen; D006650:Histocompatibility Testing; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects*; D007518:Isoantibodies; D009504:Neutrophils / Q000276:immunology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000188:drug therapy; D017452:Receptors, IgG / Q000276:immunology; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000276:immunology; D018029:Rho(D) Immune Globulin / Q000009:adverse effects*
C499173:FCGR2B protein, human; D015234:HLA-A Antigens; D059870:HLA-A11 Antigen; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; D017452:Receptors, IgG; D018029:Rho(D) Immune Globulin