Fatal TRALI associated with neutrophil antibodies in a recipient of pre-storage leukocyte-reduced blood components.
A 53-year-old man developed possible transfusion-related acute lung injury (TRALI) after red cell component transfusion. The patient developed autoimmune neutropenia with the expression of neutrophil antibodies. Neutrophil aggregation, endothelial damage, and development of a large thrombus containing platelets were observed post mortem in his pulmonary vessels. The patient also had subacute organizing pneumonia. He received blood components treated with universal pre-storage leuko-reduction. Even though leukocytes in the blood components are reduced to a few million by this process, TRALI can be fatal, as was the case for this recipient, who had subacute organizing pneumonia in conjunction with immune-mediated neutropenia.
Ishii
Kazuyoshi
K
Department of Hematology, Kishiwada City Hospital, Osaka. ishiikaz@silver.ocn.ne.jp
Kadota
Eiji
E
Shimizu
Michiomi
M
Nomura
Shosaku
S
D055371:Acute Lung Injury / Q000175:diagnosis* / Q000276:immunology*; D002449:Cell Aggregation / Q000276:immunology; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D020556:Neutrophil Infiltration / Q000276:immunology; D009504:Neutrophils / Q000276:immunology* / Q000473:pathology*