title: Anaphylactic reaction to platelet transfusion as the initial symptom of an undiagnosed systemic mastocytosis: a case report and review of the literature.
abstract: BACKGROUND
  The association between anaphylactic reactions and systemic mastocytosis is well documented. However, platelet transfusion has not previously been reported as a potential elicitor of anaphylaxis in the context of systemic mastocytosis.
  
  
  METHODS
  We describe the clinicopathological findings of a 59-year-old Latin American man who presented to the emergency room with fatigue, leukocytosis, thrombocytopenia and mild hepatosplenomegaly. He developed two separate, temporally associated and severe anaphylactic reactions after receiving platelet transfusions. The result of a laboratory investigation for clerical errors and Coombs test was negative. Pre- and post-transfusion urine samples were negative for hemolysis. Bone marrow biopsy and aspirate smears performed demonstrated involvement by systemic mastocytosis, which had been previously undiagnosed.
  
  
  CONCLUSIONS
  We posit the transfusion reaction to be an anaphylactic reaction to transfused products as a result of heightened allergic sensitivity due to the underlying systemic mastocytosis. To the best of our knowledge, this is the first reported case of a severe anaphylactic-type reaction to blood products occurring in the setting of a previously undiagnosed systemic mastocytosis. Furthermore, it seems there are no published studies closely examining the relationship between hematopoietic neoplasms and transfusion reactions in general.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center in affiliation with Jackson Memorial Hospital, Miami, FL, USA. cblieden@gmail.com.
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Blieden
authors.forename: German
authors.initials: G
authors.lastname: Campuzano-Zuluaga
authors.forename: Adrienne
authors.initials: A
authors.lastname: Moul
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Chapman
authors.forename: Maureen
authors.initials: M
authors.lastname: Cioffi-Lavina
authors.forename: Offiong F
authors.initials: OF
authors.lastname: Ikpatt
authors.forename: Gerald E
authors.initials: GE
authors.lastname: Byrne
authors.forename: Francisco
authors.initials: F
authors.lastname: Vega
mesh_terms: D000707:Anaphylaxis / Q000209:etiology*; D001853:Bone Marrow / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D034721:Mastocytosis, Systemic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects*