Ido Kentaro, Aoyama Yasutaka, Nagasaki Joji, Koh Shiro, Ichihara Hiroyoshi, Harada Hiroshi, Kawano Kiyoshi, Tani Yoshihiko, Matsuyama Nobuki, Hirayama Fumiya, Kohsaki Masatoshi, Takaku Shuji, Mugitani Atsuko
Department of Hematology, Fuchu Hospital, Japan.
Department of Hematology, Osaka City University Graduate School of Medicine, Japan.
Intern Med. 2017 Sep 15;56(18):2493-2496. doi: 10.2169/internalmedicine.8505-16. Epub 2017 Aug 21.
Transfusion-related acute lung injury (TRALI) is defined as a new episode of acute lung injury (ALI) occurring during transfusion or within 6 hours of transfusion completion. A 66-year-old man suffering from acute myeloid leukemia developed acute respiratory distress syndrome after platelet transfusion. TRALI was diagnosed clinically, but an autopsy showed leukemic cells in diffuse pulmonary edema. Anti-human neutrophil antigen (HNA)-3a antibodies were detected in the donor serum, and the HNA-3 genotype of the patient was identified as a/a. This case was considered to represent pulmonary involvement of acute myeloid leukemia, rather than TRALI. A revision of the definition of TRALI accounting for hematological malignancies should therefore be considered.
输血相关急性肺损伤（TRALI）被定义为在输血期间或输血结束后6小时内发生的急性肺损伤（ALI）新病例。一名66岁的急性髓系白血病男性在输注血小板后发生了急性呼吸窘迫综合征。临床诊断为TRALI，但尸检显示弥漫性肺水肿中有白血病细胞。在供者血清中检测到抗人类中性粒细胞抗原（HNA）-3a抗体，患者的HNA-3基因型被鉴定为a/a。该病例被认为代表急性髓系白血病的肺部受累，而非TRALI。因此，应考虑修订TRALI的定义以纳入血液系统恶性肿瘤。
