[Transfusion-related acute lung injury with anti-leukocyte antibodies identified both in patient's serum and in red cell concentrate].
We report a fatal case of transfusion-related acute lung injury (TRALI) with anti-leukocyte antibodies detected both in the patient's serum and in the causative red cell concentrate (RC-M.A.P). A 41-year-old Japanese woman diagnosed as having acute myeloid leukemia (AML, M2) developed TRALI caused by RC-M.A.P 15 days after the start of induction therapy for AML. Although we conducted intratracheal intubation, positive end-expiratory pressure ventilation, and steroid pulse therapy, she died 3 days after the onset of TRALI. We detected anti-human leukocyte antigen (HLA) class I antibody and anti-HLA class II antibody in the patient's serum and anti-neutrophil antibody in the RC-M.A.P, using the newly developed immunofluorescence tests with high specificity and low background interference. We assume that these anti-leukocyte antibodies were responsible for TRALI via an immune-mediated mechanism.
Nishizawa
Masatoshi
M
Department of Hematology, Osaka Red Cross Hospital.
Hirayama
Fumiya
F
Matsuyama
Nobuki
N
Tada
Kohei
K
Kaneko
Hitomi
H
Watanabe
Mitsumasa
M
Miura
Yasuo
Y
Tsudo
Mitsuru
M
D055371:Acute Lung Injury / Q000209:etiology*; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005455:Fluorescent Antibody Technique; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D007962:Leukocytes / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology
D001323:Autoantibodies; D006680:HLA Antigens