Sonneveld Myrthe E, Bernelot Moens Sophie J, van den Akker Jolanda, Vos Josephine M I, Kwakernaak Arjan J
Department of Haematology Amsterdam University Medical Center, University of Amsterdam Amsterdam the Netherlands.
Amsterdam University Medical Center, University of Amsterdam Amsterdam the Netherlands.
EJHaem. 2024 Oct 7;5(6):1322-1324. doi: 10.1002/jha2.1021. eCollection 2024 Dec.
Transfusion reactions occur at an estimated incidence of 2 per 1.000 transfused products. Anaphylactic transfusion reactions are rarer, and seen in 1 per 10.000 transfusions, and are mostly related to platelet transfusions. Here, we describe a rare cause of a transfusion reaction.
A 19-year-old man underwent an allogeneic haematopoietic stem cell transplantation for sickle cell disease and developed an anaphylactic shock following a platelet transfusion, after excluding all common causes. The patient reported a shrimp allergy, and one of the blood/platelet donors had consumed shrimp the day before donation. Elevated levels of specific immunoglobulin E (IgE) directed against shrimp and tropomyosin allergens were found in the patient. Subsequent transfusions were performed with apheresis platelets from selected donors who were instructed to avoid shrimp consumption, and these transfusions were uneventfully.
When a severe transfusion reaction occurs in a patient with a known food allergy, an IgE-mediated (food-related) transfusion reaction should be considered after excluding other causes.
输血反应的发生率估计为每1000份输注产品中有2例。过敏性输血反应较为罕见，每10000次输血中出现1例，且大多与血小板输注有关。在此，我们描述一种罕见的输血反应原因。
一名19岁男性因镰状细胞病接受了异基因造血干细胞移植，在排除所有常见原因后，输血后发生过敏性休克。患者报告有虾过敏史，其中一名血液/血小板捐献者在献血前一天食用了虾。在患者体内发现针对虾和原肌球蛋白过敏原的特异性免疫球蛋白E（IgE）水平升高。随后使用来自选定捐献者的单采血小板进行输血，这些捐献者被要求避免食用虾，输血过程顺利。
当已知有食物过敏的患者发生严重输血反应时，在排除其他原因后应考虑IgE介导（与食物相关）的输血反应。
