Fine Antonella B, Sweeney Joseph D, Nixon Christian P, Knoll Bettina M
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Transfusion Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Transfusion. 2016 Mar;56(3):699-704. doi: 10.1111/trf.13392. Epub 2015 Dec 9.
Human granulocytic anaplasmosis is an emerging tick-borne illness. Anaplasma phagocytophilum resides intracellularly, can cause asymptomatic infection, and can survive blood component refrigeration conditions for at least 18 days. To date, eight cases of transfusion-transmitted anaplasmosis (TTA) have been reported: seven attributed to red blood cell (RBC) units, five of which were prestorage leukoreduced using RBC leukoreduction filters, and one involving a process leukoreduced apheresis platelet (PLT) unit. Here, we report a case of TTA from a whole blood-derived PLT pool.
Donation segments from the 7 units of RBCs and two PLT pools transfused were examined. Fast protocol multiplex real-time A. phagocytophilum polymerase chain reaction (PCR) and serologic testing for immunoglobulin (Ig)M and IgG antibodies to A. phagocytophilum by enzyme immunoassay were performed.
Transmission was confirmed by positive A. phagocytophilum PCR and serology in one of 16 donors and by positive PCR and seroconversion in the recipient.
This is the first confirmed case of TTA from a whole blood-derived PLT pool prepared from PLT concentrates leukoreduced by in-line filtration of PLT-rich plasma.
人粒细胞无形体病是一种新出现的蜱传疾病。嗜吞噬细胞无形体寄生于细胞内，可引起无症状感染，并且能够在血液成分冷藏条件下存活至少18天。迄今为止，已报告8例输血传播无形体病（TTA）：7例归因于红细胞（RBC）单位，其中5例使用红细胞白细胞滤除器进行了储存前白细胞去除，1例涉及经过白细胞去除处理的单采血小板（PLT）单位。在此，我们报告1例来自全血来源血小板池的TTA病例。
对输注的7个红细胞单位和两个血小板池的献血片段进行检测。采用快速方案多重实时嗜吞噬细胞无形体聚合酶链反应（PCR），并通过酶免疫测定法对嗜吞噬细胞无形体的免疫球蛋白（Ig）M和IgG抗体进行血清学检测。
16名献血者中有1名的嗜吞噬细胞无形体PCR和血清学检测呈阳性，受血者PCR呈阳性且血清学发生转换，从而证实了传播。
这是首例经证实的TTA病例，该病例来自通过对富含血小板血浆进行在线过滤白细胞去除后制备的全血来源血小板池。
