title: HLA-DR antibodies in transfusion-related acute lung injury (TRALI): a case report.
abstract: Transfusion-related acute lung injury (TRALI) is a serious adverse consequence of blood product transfusion. Cases of TRALI have gone unrecognized or misdiagnosed, since the symptoms can be confused with other transfusion-related events or with non-transfusion related comorbidities. Suspected cases of TRALI may be insufficiently investigated, and mild or moderate cases may not be investigated or reported at all. We report here the case of a 73-year man who developed TRALI following a transfusion of packed red blood cells (pRBCs) mediated by HLA class II antibodies (HLA-DR) detected by luminex technology. A very few cases of TRALI have been described being caused by HLA class II antibodies without the simultaneous presence of anti-HLA class I antibodies. Technology for antibody detection has increased the power and the specificity, especially with the use of flow cytometry with a better definition of the antigen/antibody pairs that have resulted in TRALI episodes. In this sense, HLA class II antibodies can exactly be detected with these methods and have surely been underestimated until now.
authors.affiliation: University Hospital Virgen Arrixaca, Immunology Service, Murcia, Spain. manuel.muro@carm.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Muro
authors.forename: Jose
authors.initials: J
authors.lastname: Rivera
authors.forename: Carmen
authors.initials: C
authors.lastname: Botella
authors.forename: Jose A
authors.initials: JA
authors.lastname: Campillo
authors.forename: Francisca
authors.initials: F
authors.lastname: Ferrer
authors.forename: María R
authors.initials: MR
authors.lastname: Alvarez-López
mesh_terms: D055371:Acute Lung Injury / Q000097:blood* / Q000209:etiology; D000368:Aged; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D006684:HLA-DR Antigens; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male
chemical_list: D006684:HLA-DR Antigens; D007518:Isoantibodies