Two Cases of Transfusion-related Acute Lung Injury Triggered by HLA and Anti-HLA Antibody Reaction.
10.3346/jkms.2010.25.9.1398
- Author:
Ji Hyun LEE
1
;
Eun Suk KANG
;
Dae Won KIM
Author Information
1. Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. eskang@skku.edu
- Publication Type:Case Report
- Keywords:
Adverse Transfusion Reaction;
Transfusion-Related Acute Lung Injury (TRALI);
Anti-HLA Antibody
- MeSH:
Acute Lung Injury/*diagnosis/*immunology/radiography;
Aged;
Anoxia/diagnosis;
Antigen-Antibody Reactions;
Blood Transfusion/*adverse effects;
Dyspnea/diagnosis;
Female;
HLA Antigens/*immunology;
Histocompatibility Antigens Class I/immunology;
Histocompatibility Antigens Class II/immunology;
Humans;
Isoantibodies/*blood;
Male;
Middle Aged
- From:Journal of Korean Medical Science
2010;25(9):1398-1403
- CountryRepublic of Korea
- Language:English
-
Abstract:
Transfusion-related acute lung injury (TRALI) is a serious adverse transfusion reaction that is presented as acute hypoxemia and non-cardiogenic pulmonary edema, which develops during or within 6 hr of transfusion. Major pathogenesis of TRALI is known to be related with anti-HLA class I, anti-HLA class II, or anti-HNA in donor's plasma. However, anti-HLA or anti-HNA in recipient against transfused donor's leukocyte antigens also cause TRALI in minor pathogenesis and which comprises about 10% of TRALI. Published reports of TRALI are relatively rare in Korea. In our cases, both patients presented with dyspnea and hypoxemia during transfusion of packed red blood cells and showed findings of bilateral pulmonary infiltrations at chest radiography. Findings of patients' anti-HLA antibodies and recipients' HLA concordance indicate that minor pathogenesis may be not as infrequent as we'd expected before. In addition, second case showed that anti-HLA class II antibodies could be responsible for immunopathogenic mechanisms, alone.
