Premium
Atopic predisposition of recipients in allergic transfusion reactions to apheresis platelets
Author(s) -
Savage William J.,
Tobian Aaron A.R.,
Savage Jessica H.,
Hamilton Robert G.,
Ness Paul M.
Publication year - 2011
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.1537-2995.2011.03160.x
Subject(s) - medicine , immunoglobulin e , apheresis , immunology , aeroallergen , allergy , atopy , sensitization , anaphylaxis , platelet , allergen , antibody
BACKGROUND: The biologic mechanisms of allergic transfusion reactions (ATRs) are largely unknown. We sought to compare the atopic predisposition of platelet (PLT) recipients who experienced an ATR to nonreactive control recipients. STUDY DESIGN AND METHODS: We identified 37 consecutive apheresis PLT recipients who experienced an ATR and 26 matched controls. Total immunoglobulin (Ig)E and aero‐ and food allergen–specific IgE were quantified in plasma by a blood test for allergies (ImmunoCAP: Phadiatop and Fx5). IgE testing of apheresis PLT supernatants was also performed. RESULTS: Pruritus and urticaria were manifest in 91.9 and 83.8% of all ATRs, with more severe respiratory symptoms and angioedema occurring in less than 15% of cases. No subject had anaphylaxis. Sex, age, and primary diagnosis were balanced between the two groups. Total and aeroallergen‐specific IgE was higher among subjects experiencing an ATR in comparison to control subjects (median total IgE, 55.5 kU/L vs. 8.3 kU/L, p = 0.002; and median aeroallergen‐specific IgE, 0.57 kUa/L vs. 0.36 kUa/L, p = 0.046). IgE antibody levels in apheresis products associated with ATRs were similar to control products (p > 0.1 for all IgE tests). CONCLUSION: Recipient atopic predisposition, as defined by IgE sensitization, is a risk factor associated with ATRs.