Document Detail


Successful desensitization to immunoglobulin A in a case of transfusion-related anaphylaxis.
MedLine Citation:
PMID:  20456696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A history of anaphylaxis after transfusion of immunoglobulin A (IgA)-containing blood products in selective IgA-deficient (sIgAD) patients can be a major problem, particularly in emergencies, when large quantities of blood products are required.
CASE REPORT: A 19-year-old woman with end-stage Type 2 autoimmune hepatitis required liver transplantation as her only remaining treatment option. However, she also had sIgAD, anti-IgA antibodies, and episodes of anaphylaxis after receiving IgA-containing blood products. Liver transplantation would have been extremely challenging due to the difficulty of obtaining sufficient blood products from suitable IgA-deficient donors. Hence, it became imperative to devise a protocol to desensitize her to IgA-containing blood products.
RESULTS: Using a continuous infusion of an IgA-enriched (6 mg/mL IgA) immunoglobulin preparation with gradual increases in concentration, she was successfully desensitized to IgA. Consequently, she was able to receive standard platelets, fresh-frozen plasma, and red blood cells with no complications.
CONCLUSION: This approach could prove very useful in similar cases that may require administration of large quantities of blood products particularly in emergency lifesaving circumstances.
Authors:
Sorena Kiani-Alikhan; Patrick F K Yong; Dorothea Grosse-Kreul; Susan E Height; Aleksandar Mijovic; Abid R Suddle; Mohammad A A Ibrahim
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  50     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-05     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1897-901     Citation Subset:  IM    
Copyright Information:
© 2010 American Association of Blood Banks.
Affiliation:
Department of Clinical Immunology and Allergy, Institute of Liver Studies, King's College Hospital, London, UK. skiani@nhs.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Anaphylaxis / etiology*,  immunology,  prevention & control*
Blood Transfusion / adverse effects*
Female
Humans
Immunoglobulin A / immunology*,  therapeutic use*
Young Adult
Chemical
Reg. No./Substance:
0/Immunoglobulin A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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