Allergic transfusion reaction

Background

• Occurs due to immune response to plasma proteins
• Reaction severity not dose-related
• Most frequently occurs with platelet transfusions

Clinical Features

• Symptoms range from urticaria/pruritus to bronchospasm, wheezing, anaphylaxis (rare)

Differential Diagnosis

Transfusion Reaction Types

• Acute
  • Intravascular hemolytic tranfusion reaction
  • Febrile nonhemolytic tranfusion reaction
  • Allergic tranfusion reaction
  • Transfusion-associated circulatory overload (TACO)
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated graft-versus-host disease
  • Fluid overload
  • Sepsis
• Delayed
  • Extravascular hemolytic tranfusion reaction
  • Graft-vs-host disease
  • Transfusion infections

Acute allergic reaction

• Allergic reaction/urticaria
• Anaphylaxis
• Angioedema
• Anxiety attack
• Asthma exacerbation
• Carcinoid syndrome
• Cold urticaria
• Contrast induced allergic reaction
• Scombroid
• Shock
• Transfusion reaction

Evaluation

• May need to rule out hemolysis - see transfusion reaction

Management

• Stop transfusion until able to evaluate severity of allergic reaction
• Give diphenhydramine
• Restart transfusion if symptoms are mild

See Also

• Transfusion reaction
• Acute allergic reaction