Successful desensitization to immunoglobulin A in a case of transfusion-related anaphylaxis
Version of Record online: 30 APR 2010
© 2010 American Association of Blood Banks
Volume 50, Issue 9, pages 1897–1901, September 2010
How to Cite
Kiani-Alikhan, S., Yong, P. F.K., Grosse-Kreul, D., Height, S. E., Mijovic, A., Suddle, A. R. and Ibrahim, M. A.A. (2010), Successful desensitization to immunoglobulin A in a case of transfusion-related anaphylaxis. Transfusion, 50: 1897–1901. doi: 10.1111/j.1537-2995.2010.02662.x
- Issue online: 1 SEP 2010
- Version of Record online: 30 APR 2010
- Received for publication November 29, 2009; revision received February 22, 2010; and accepted February 24, 2010.
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.