Transfusion-related acute lung injury due to granulocyte-agglutinating antibody in a patient with paroxysmal nocturnal hemoglobinuria.

摘要: BACKGROUND: Transfusion-related acute lung injury (TRALI) is usually reported after the transfusion of blood components from donors with white cell (WBC) antibodies, but only very rarely if patient has these antibodies. The pathogenesis TRALI not fully understood. Not all recipients develop TRALI, even though WBC antibodies are present in donor or recipient. CASE REPORT: A paroxysmal nocturnal hemoglobinuria (PNH) who developed non-WBC-reduced red cells described. Granulocyte-agglutinating anti-5b was detected his serum, and crossmatch granulocytes positive. also a severe exacerbation hemolysis renal failure; serologic results excluded an immune hemolytic posttransfusion reaction. recovered both events about 1 week. CONCLUSION: recipient play important role other factors may contribute to its pathogenesis. reaction between PNH patient's antibody (anti-5b) transfused WBCs found be responsible for respiratory distress have triggered, through innocent-bystander mechanism complement activation, intensive hemolysis, which likely contributing factor development TRALI.