title: [Transfusion-related acute lung injury with anti-leukocyte antibodies identified both in patient's serum and in red cell concentrate].
abstract: 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.
authors.affiliation: Department of Hematology, Osaka Red Cross Hospital.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nishizawa
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hirayama
authors.forename: Nobuki
authors.initials: N
authors.lastname: Matsuyama
authors.forename: Kohei
authors.initials: K
authors.lastname: Tada
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kaneko
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Tsudo
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens