Transfusion-related acute lung injury (TRALI) induced by donor-derived anti-HLA antibodies in aplastic anemia: possible priming effect of granulocyte-colony stimulating factor (G-CSF) on the recipient neutrophils.
Transfusion-related acute lung injury (TRALI) is currently the leading cause of transfusion-related death. A 67-year-old man with severe aplastic anemia developed TRALI, consisting of acute respiratory insufficiency with severe hypoxia and diffuse pulmonary infiltration 2 hours after the transfusion of platelet concentrates. Although he required intensive respiratory support, he promptly recovered within 4 days. The presence of anti-HLA antibody (anti-HLA B52) in the donated blood product was demonstrated, and a lymphocytotoxicity test disclosed antibody-mediated cytotoxicity against the patient's cells. Furthermore, administration of granulocyte-colony stimulating factor was suggested to predispose the patient to TRALI by priming the neutrophils.
Hishizawa
Masakatsu
M
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto.
Mitsuhashi
Ryuichi
R
Ohno
Tatsuharu
T
D055371:Acute Lung Injury / Q000209:etiology* / Q000276:immunology; D000368:Aged; D000741:Anemia, Aplastic / Q000276:immunology / Q000628:therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000276:immunology*; D015235:HLA-B Antigens / Q000097:blood / Q000276:immunology*; D059950:HLA-B52 Antigen; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D009504:Neutrophils / Q000187:drug effects / Q000276:immunology*; D065227:Transfusion Reaction
D015235:HLA-B Antigens; D059950:HLA-B52 Antigen; D007518:Isoantibodies; D016179:Granulocyte Colony-Stimulating Factor