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经白细胞减少的红细胞传播的输血传播无形体病。

Transfusion-transmitted anaplasmosis from leukoreduced red blood cells.

机构信息

Blood Bank and Transfusion Medicine, the Division of Infectious Disease, The Miriam Hospital, and the Rhode Island Blood Center, Providence, Rhode Island; and Imugen, Inc., Norwood, Massachusetts, USA.

出版信息

Transfusion. 2013 Jan;53(1):181-6. doi: 10.1111/j.1537-2995.2012.03685.x. Epub 2012 May 7.

Abstract

BACKGROUND

Human granulocytic anaplasmosis (HGA) is a tick-borne rickettsial infectious disease. To date four cases of transfusion-transmitted anaplasmosis (TTA) have been described in the literature, and only one from leukoreduced red blood cells (RBCs).

CASE REPORT

A 64-year-old patient with acute gastrointestinal blood loss was admitted to the hospital and received 5 units of prestorage leukoreduced RBCs. He was stabilized and discharged. He developed headache, fever, and chills 2 days after discharge and was readmitted. On Day 5 of his second admission polymorphonuclear leukocytes containing morulae consistent with HGA were reported in the peripheral smear.

RESULTS

Samples from the recipient tested positive by polymerase chain reaction (PCR) for Anaplasma phagocytophilum, the causative agent of HGA and a segment from one of the five donors tested positive by both serology and PCR.

CONCLUSION

Leukoreduction theoretically reduces the risk of TTA but does not interdict all infections. TTA requires consideration in recipients of RBC transfusion with unexplained fever.

摘要

背景

人粒细胞无形体病(HGA)是一种蜱传立克次体传染病。迄今为止,文献中描述了 4 例输血传播的无形体病(TTA),并且仅来自去白细胞的红细胞(RBC)。

病例报告

一名 64 岁的急性胃肠道出血患者被收入院,并接受了 5 单位的储存前去白细胞 RBC。他稳定后出院。出院后 2 天,他出现头痛、发热和寒战,并再次入院。在第二次入院的第 5 天,外周血涂片报告发现含有与 HGA 一致的桑葚体的多形核白细胞。

结果

受者样本通过聚合酶链反应(PCR)检测出人粒细胞无形体(HGA 的病原体)阳性,并且五个供者之一的样本通过血清学和 PCR 均呈阳性。

结论

去白细胞理论上降低了 TTA 的风险,但并不能阻断所有感染。对于不明原因发热的 RBC 输血受者,应考虑 TTA。

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