Posttransfusion anaphylactic reactions in a patient with severe von Willebrand disease: role of complement and alloantibodies to von Willebrand factor.

摘要: Previous studies have suggested that activation of the complement system might be a major mechanism for posttransfusion non-immunoglobulin (Ig) E-mediated anaphylactic reactions, but its causative effect has not been clearly demonstrated in human models. Serial plasma samples were collected from patient with severe von Willebrand disease, IgG alloantibodies against factor (vWF), and history anaphylaxis. During an 18-day period was treated VIII-vWF concentrate recombinant VIII. Complement assessed levels C4a, C3a, cleavage products B, soluble terminal complex, C1 inhibitor C4-binding protein, contact phase coagulation activated XII cleaved high-molecular-weight kininogen. Plasma antibodies to vWF complement-fixing IgG-vWF complexes also evaluated. Symptoms anaphylaxis signs present only when measurable during replacement (days 1 6). IgE, IgA, IgM detectable at any time. Replacement VIII 7 18) secured hemostasis did elicit parameters significantly change even reached peak levels. This prospective study natural clinical model indicates cause-effect relationship between formation massive non-IgE-mediated reactions.(ABSTRACT TRUNCATED AT 250 WORDS)