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Successful desensitization to immunoglobulin A in a case of transfusion‐related anaphylaxis
Author(s) -
KianiAlikhan Sorena,
Yong Patrick F.K.,
GrosseKreul Dorothea,
Height Susan E.,
Mijovic Aleksandar,
Suddle Abid R.,
Ibrahim Mohammad A.A.
Publication year - 2010
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2010.02662.x
Subject(s) - medicine , anaphylaxis , desensitization (medicine) , antibody , immunoglobulin e , immunology , liver transplantation , blood transfusion , transplantation , allergy , receptor
BACKGROUND: A history of anaphylaxis after transfusion of immunoglobulin A (IgA)‐containing blood products in selective IgA‐deficient (sIgAD) patients can be a major problem, particularly in emergencies, when large quantities of blood products are required. CASE REPORT: A 19‐year‐old woman with end‐stage Type 2 autoimmune hepatitis required liver transplantation as her only remaining treatment option. However, she also had sIgAD, anti‐IgA antibodies, and episodes of anaphylaxis after receiving IgA‐containing blood products. Liver transplantation would have been extremely challenging due to the difficulty of obtaining sufficient blood products from suitable IgA‐deficient donors. Hence, it became imperative to devise a protocol to desensitize her to IgA‐containing blood products. RESULTS: Using a continuous infusion of an IgA‐enriched (6 mg/mL IgA) immunoglobulin preparation with gradual increases in concentration, she was successfully desensitized to IgA. Consequently, she was able to receive standard platelets, fresh‐frozen plasma, and red blood cells with no complications. CONCLUSION: This approach could prove very useful in similar cases that may require administration of large quantities of blood products particularly in emergency lifesaving circumstances.