Relative IgA‐deficient recipients have an increased risk of severe allergic transfusion reactions
Identifieur interne : 000695 ( Istex/Corpus ); précédent : 000694; suivant : 000696Relative IgA‐deficient recipients have an increased risk of severe allergic transfusion reactions
Auteurs : W. Anani ; D. Triulzi ; M. H. Yazer ; L. QuSource :
- Vox Sanguinis [ 0042-9007 ] ; 2014-11.
Abstract
Absolute IgA deficiency is the most common immunodeficiency in the Western world. These patients are at risk of severe allergic reactions when receiving a transfusion with a plasma‐containing blood product. However, it is unclear whether patients with relative IgA deficiency, that is levels below detection on routine assays, are also at risk of severe reactions. This retrospective study evaluated the number of severe allergic transfusion reactions in relative IgA‐deficient patients who were transfused with unwashed blood products.
Url:
DOI: 10.1111/vox.12192
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<front><div type="abstract">Absolute IgA deficiency is the most common immunodeficiency in the Western world. These patients are at risk of severe allergic reactions when receiving a transfusion with a plasma‐containing blood product. However, it is unclear whether patients with relative IgA deficiency, that is levels below detection on routine assays, are also at risk of severe reactions. This retrospective study evaluated the number of severe allergic transfusion reactions in relative IgA‐deficient patients who were transfused with unwashed blood products.</div>
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<profileDesc><abstract style="main" xml:id="vox12192-abs-0001">
Background
<p>Absolute IgA deficiency is the most common immunodeficiency in the Western world. These patients are at risk of severe allergic reactions when receiving a transfusion with a plasma‐containing blood product. However, it is unclear whether patients with relative IgA deficiency, that is levels below detection on routine assays, are also at risk of severe reactions. This retrospective study evaluated the number of severe allergic transfusion reactions in relative IgA‐deficient patients who were transfused with unwashed blood products.</p>
Study Design and Methods
<p>Patients who had an IgA measurement performed for any reason over a 10‐year period were compared with a list of transfusion recipients over the same period. Those who had both an IgA measurement and a transfusion were then compared with the transfusion reaction database to determine whether an allergic reaction had been reported, and if so, the severity of the reaction. Patients with IgA concentrations of <7 mg/<hi rend="fc">dL</hi>
were defined as relative IgA deficient.</p>
Results
<p>Of the 22 362 IgA measurements performed on 19 737 patients over 10 years, a total of 168 relative IgA‐deficient patients were identified; 39 of these patients were also transfusion recipients and 4 of 39 (10%) experienced a severe allergic transfusion reaction (<hi rend="fc">SALTR</hi>
). Eight <hi rend="fc">SALTR</hi>
s were reported amongst 1545 (0·52%) IgA replete transfusion recipients.</p>
Conclusion
<p>The significantly increased risk of <hi rend="fc">SALTR</hi>
s in relative IgA‐deficient patients warrants consideration of premedications and/or washing of plasma‐containing blood products.</p>
</abstract>
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Lirong Qu, The Institute for Transfusion Medicine, 3636 Blvd of Allies, Pittsburgh, PA 15213, USA</line>
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<abstractGroup><abstract type="main" xml:id="vox12192-abs-0001"><section xml:id="vox12192-sec-0001"><title type="main">Background</title>
<p>Absolute IgA deficiency is the most common immunodeficiency in the Western world. These patients are at risk of severe allergic reactions when receiving a transfusion with a plasma‐containing blood product. However, it is unclear whether patients with relative IgA deficiency, that is levels below detection on routine assays, are also at risk of severe reactions. This retrospective study evaluated the number of severe allergic transfusion reactions in relative IgA‐deficient patients who were transfused with unwashed blood products.</p>
</section>
<section xml:id="vox12192-sec-0002"><title type="main">Study Design and Methods</title>
<p>Patients who had an IgA measurement performed for any reason over a 10‐year period were compared with a list of transfusion recipients over the same period. Those who had both an IgA measurement and a transfusion were then compared with the transfusion reaction database to determine whether an allergic reaction had been reported, and if so, the severity of the reaction. Patients with IgA concentrations of <7 mg/<fc>dL</fc>
were defined as relative IgA deficient.</p>
</section>
<section xml:id="vox12192-sec-0003"><title type="main">Results</title>
<p>Of the 22 362 IgA measurements performed on 19 737 patients over 10 years, a total of 168 relative IgA‐deficient patients were identified; 39 of these patients were also transfusion recipients and 4 of 39 (10%) experienced a severe allergic transfusion reaction (<fc>SALTR</fc>
). Eight <fc>SALTR</fc>
s were reported amongst 1545 (0·52%) IgA replete transfusion recipients.</p>
</section>
<section xml:id="vox12192-sec-0004"><title type="main">Conclusion</title>
<p>The significantly increased risk of <fc>SALTR</fc>
s in relative IgA‐deficient patients warrants consideration of premedications and/or washing of plasma‐containing blood products.</p>
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<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Relative IgA‐deficient recipients have an increased risk of severe allergic transfusion reactions</title>
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<name type="personal"><namePart type="given">W.</namePart>
<namePart type="family">Anani</namePart>
<affiliation>Department of Pathology, University of Pittsburgh, PA, Pittsburgh, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">D.</namePart>
<namePart type="family">Triulzi</namePart>
<affiliation>Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA</affiliation>
<affiliation>Institute for Transfusion Medicine, PA, Pittsburgh, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">M. H.</namePart>
<namePart type="family">Yazer</namePart>
<affiliation>Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA</affiliation>
<affiliation>Institute for Transfusion Medicine, PA, Pittsburgh, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">L.</namePart>
<namePart type="family">Qu</namePart>
<affiliation>Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA</affiliation>
<affiliation>Institute for Transfusion Medicine, PA, Pittsburgh, USA</affiliation>
<affiliation>Lirong Qu, The Institute for Transfusion Medicine, 3636 Blvd of Allies, Pittsburgh, PA 15213, USAE‐mail:</affiliation>
<affiliation>E-mail: lqu@itxm.org</affiliation>
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<originInfo><publisher>Blackwell Publishing Ltd</publisher>
<dateIssued encoding="w3cdtf">2014-11</dateIssued>
<dateCreated encoding="w3cdtf">2014-08-21</dateCreated>
<dateCaptured encoding="w3cdtf">2014-06-20</dateCaptured>
<dateValid encoding="w3cdtf">2014-08-11</dateValid>
<copyrightDate encoding="w3cdtf">2014</copyrightDate>
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<abstract>Absolute IgA deficiency is the most common immunodeficiency in the Western world. These patients are at risk of severe allergic reactions when receiving a transfusion with a plasma‐containing blood product. However, it is unclear whether patients with relative IgA deficiency, that is levels below detection on routine assays, are also at risk of severe reactions. This retrospective study evaluated the number of severe allergic transfusion reactions in relative IgA‐deficient patients who were transfused with unwashed blood products.</abstract>
<abstract>Patients who had an IgA measurement performed for any reason over a 10‐year period were compared with a list of transfusion recipients over the same period. Those who had both an IgA measurement and a transfusion were then compared with the transfusion reaction database to determine whether an allergic reaction had been reported, and if so, the severity of the reaction. Patients with IgA concentrations of <7 mg/dL were defined as relative IgA deficient.</abstract>
<abstract>Of the 22 362 IgA measurements performed on 19 737 patients over 10 years, a total of 168 relative IgA‐deficient patients were identified; 39 of these patients were also transfusion recipients and 4 of 39 (10%) experienced a severe allergic transfusion reaction (SALTR). Eight SALTRs were reported amongst 1545 (0·52%) IgA replete transfusion recipients.</abstract>
<abstract>The significantly increased risk of SALTRs in relative IgA‐deficient patients warrants consideration of premedications and/or washing of plasma‐containing blood products.</abstract>
<subject><genre>keywords</genre>
<topic>allergic</topic>
<topic>IgA deficiency</topic>
<topic>premedication</topic>
<topic>reaction</topic>
<topic>transfusion</topic>
<topic>washing</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Vox Sanguinis</title>
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<titleInfo type="abbreviated"><title>Vox Sang</title>
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<genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre>
<subject><genre>article-category</genre>
<topic>Original Paper</topic>
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<identifier type="ISSN">0042-9007</identifier>
<identifier type="eISSN">1423-0410</identifier>
<identifier type="DOI">10.1111/(ISSN)1423-0410</identifier>
<identifier type="PublisherID">VOX</identifier>
<part><date>2014</date>
<detail type="volume"><caption>vol.</caption>
<number>107</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>4</number>
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<extent unit="pages"><start>389</start>
<end>392</end>
<total>4</total>
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<identifier type="istex">1E07A92801FDB92BE8AD421F387CCBF52C55CCB8</identifier>
<identifier type="ark">ark:/67375/WNG-017L3NS9-2</identifier>
<identifier type="DOI">10.1111/vox.12192</identifier>
<identifier type="ArticleID">VOX12192</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2014 International Society of Blood Transfusion© 2014 International Society of Blood Transfusion</accessCondition>
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