Scientific Affairs, American Red Cross, Rockville, Maryland, USA.
Division of Infectious Diseases, Stony Brook University Hospital, Stony Brook, New York, USA.
Transfusion. 2024 Apr;64(4):751-754. doi: 10.1111/trf.17783. Epub 2024 Mar 16.
Anaplasma phagocytophilum is a tick-borne bacterium and the cause of human granulocytic anaplasmosis (HGA). Here, we report a case of transfusion-transmitted (TT)-HGA involving a leukoreduced (LR) red blood cell (RBC) unit.
A 64-year-old woman with gastric adenocarcinoma and multiple myeloma who received weekly blood transfusions developed persistent fevers, hypotension, and shortness of breath 1 week after receiving an RBC transfusion. Persistent fevers, new thrombocytopenia, and transaminitis suggested a tick-borne infection.
The absence of blood parasites on thick and thin blood smears suggested that malaria and Babesia infection were not present, and the recipient tested negative for antibodies to Borrelia burgdorferi. Blood testing by polymerase chain reaction (PCR) for Ehrlichia and Anaplasma species identified A. phagocytophilum. Treatment with doxycycline resolved the infection; however, the recipient expired due to complications of her known malignancies. The recipient lived in a nursing home and did not have pets or spend time outdoors. The donor was a female in her 70s from Maine who was diagnosed with HGA 3 weeks after donating blood and whose LR-RBCs from the donation were transfused to the recipient 9 days following collection.
This is a confirmed case of TT-HGA. Although rare, TT-HGA has been reported with LR-RBCs and platelets. In endemic areas, testing for tick-borne associated infections should be considered when investigating post-transfusion complications.
嗜吞噬细胞无形体是一种蜱传细菌，也是人类粒细胞无形体病（HGA）的病原体。在此，我们报告了一例涉及去白细胞（LR）红细胞（RBC）的输血传播（TT）-HGA 病例。
一名 64 岁女性，患有胃腺癌和多发性骨髓瘤，每周接受输血，在接受 RBC 输血后 1 周出现持续性发热、低血压和呼吸急促。持续性发热、新出现的血小板减少和肝功能异常提示存在蜱传感染。
厚、薄血涂片均未发现血液寄生虫，表明不存在疟疾和巴贝虫感染，且受血者对伯氏疏螺旋体的抗体检测呈阴性。聚合酶链反应（PCR）血液检测鉴定出嗜吞噬细胞无形体。多西环素治疗缓解了感染；然而，由于其已知恶性肿瘤的并发症，受血者死亡。受血者居住在疗养院，没有宠物，也不在户外活动。供者为缅因州 70 多岁的女性，在献血后 3 周被诊断为 HGA，其献血后 9 天采集的 LR-RBC 输给了受血者。
这是一例确诊的 TT-HGA 病例。尽管罕见，但已报道过 LR-RBC 和血小板的 TT-HGA。在流行地区，当调查输血后并发症时，应考虑进行与蜱传感染相关的检测。
