HLA-DR antibodies in transfusion-related acute lung injury (TRALI): a case report.
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.
Muro
Manuel
M
University Hospital Virgen Arrixaca, Immunology Service, Murcia, Spain. manuel.muro@carm.es
Rivera
Jose
J
Botella
Carmen
C
Campillo
Jose A
JA
Ferrer
Francisca
F
Alvarez-López
María R
MR
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
D006684:HLA-DR Antigens; D007518:Isoantibodies