Case report: four donors with granulocyte-specific or HLA class I antibodies implicated in a case of transfusion-related acute lung injury (TRALI)
| Autor: | Christopher Barnes, Lucas Gf, Smith Op, Emer Lawlor, A. Davoren, Evans Rg |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Lung
business.industry Hematology General Medicine 030204 cardiovascular system & hematology Lung injury Chronic liver disease medicine.disease Serology Hypoxemia 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Anesthesia Immunology medicine Coagulopathy Immunology and Allergy Fresh frozen plasma medicine.symptom business Transfusion-related acute lung injury |
| Zdroj: | Immunohematology. 17:117-121 |
| ISSN: | 1930-3955 |
| Popis: | A 54-year-old female patient with a history of chronic liver disease and portal hypertension was admitted for an elective cholecystectomy. Preoperative evaluation revealed a prolonged prothrombin time of 17.4 seconds (control 12 to 15.5 seconds). Six units of fresh frozen plasma (FFP) were prescribed after failure of correction of the coagulopathy with intravenous vitamin K (10 mgs). During infusion of the fifth unit of FFP, the patient became acutely dyspneic. Arterial blood gas analysis revealed marked hypoxemia (PO2 6.58 kPa) and the chest X-ray showed new diffuse bilateral alveolar infiltrates. The patient remained hypoxemic with unstable oxygen saturations over the following 7 days, during which time she required 60 to 100 percent oxygen administered by face mask. Intravenous methylprednisolone (200 mgs) was given for 5 days. Mechanical ventilation was not required. The lung infiltrates gradually cleared over 3 to 4 days and the patient showed clinical improvement after 1 week. Four of the donors of the implicated units of plasma were female and all had a history of pregnancy. Two donors had HLA class I antibodies and two had granulocytespecific antibodies detectable in their serum. In crossmatch studies, granulocyte-reactive antibodies from two donors bound to granulocytes from the patient, which suggested that these antibodies were clinically relevant. These clinical and serologic findings support a diagnosis of transfusion-related acute lung injury (TRALI). Immunohematology 2001;17:117–121. |
| Databáze: | OpenAIRE |
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