Selective IgA Deficiency and Blood Component Transfusion: In Search of the Lost Evidence
Abstract
:1. Introduction
2. Methods
3. Results
3.1. IgA-D prevalence in Hematologic Patients
3.2. Transfusion in Patients with IgA-D
3.3. Allergic/Anaphylactic Transfusion Reaction Characteristics and IgA Levels
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- European Society for Immunodeficiencies, IgA Deficiency Diagnostic Criteria. Available online: https://esid.org/working-parties/registryworking-party-diagnosis-criteria (accessed on 2 July 2023).
- Yazdani, R.; Azizi, G.; Abolhassani, H.; Aghamohammadi, A. Selective IgA deficiency: Epidemiology, Pathogenesis, Clinical Phenotype, Diagnosis, Prognosis and Management. Scand. J. Immunol. 2017, 85, 3–12. [Google Scholar] [CrossRef] [PubMed]
- Vassallo, R.R. Review: IgA anaphylactic transfusion reactions. Part I. Laboratory diagnosis, incidence, and supply of IgA-deficient products. Immunohematology 2004, 20, 226–233. [Google Scholar] [CrossRef] [PubMed]
- Sandler, S.G.; Mallory, D.; Malamut, D.; Eckrich, R. IgA anaphylactic transfusion reactions. Transfus. Med. Rev. 1995, 9, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Khandelwal, A.; Clarke, G.; Goldman, M. Anaphylactic Transfusion Reactions and IgA Deficiency [Internet]; Canadian Blood Services: Ottawa, ON, Canada, 2021; Available online: https://professionaleducation.blood.ca/en/transfusion/publications/anaphylactic-transfusion-reactions-and-iga-deficiency (accessed on 20 August 2023).
- Zantek, N.D.; Parker, R.I.; van de Watering, L.M.; Josephson, C.D.; Bateman, S.T.; Valentine, S.L.; Delaney, M. Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI); Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Recommendations on Selection and Processing of RBC Components for Pediatric Patients From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatr. Crit. Care Med. 2018, 19, S163–S169. [Google Scholar] [PubMed]
- Serious Hazards of Transfusion (SHOT). Serious Hazards of Transfusion Report 2021; Annual SHOT Report; Serious Hazards of Transfusion (SHOT): Manchester, UK, 2021. [Google Scholar]
- Sandler, S.G.; Eder, A.F.; Goldman, M.; Winters, J.L. The entity of immunoglobulin A-related anaphylactic transfusion reactions is not evidence based. Transfusion 2015, 55, 199–204. [Google Scholar] [CrossRef] [PubMed]
- Swain, S.; Selmi, C.; Gershwin, M.E.; Teuber, S.S. The clinical implications of selective IgA deficiency. J. Transl. Autoimmun. 2019, 2, 100025. [Google Scholar] [CrossRef] [PubMed]
- Pereira, L.F.; Sapiña, A.M.; Arroyo, J.; Viñuelas, J.; Bardají, R.M.; Prieto, L. Prevalence of selective IgA deficiency in Spain: More than we thought. Blood 1997, 90, 893. [Google Scholar] [CrossRef] [PubMed]
- Vyas, G.N.; Perkins, H.A.; Fudenburg, H.H. Anaphylactoid transfusion reactions associated with anti-IgA. Lancet 1968, 2, 312–315. [Google Scholar] [CrossRef] [PubMed]
- Goel, R.; Tobian, A.A.R.; Shaz, B.H. Non-infectious transfusion-associated adverse events and their mitigation strategies. Blood 2019, 133, 1831–1839. [Google Scholar] [CrossRef]
- Miller, W.V.; Holland, P.V.; Sugarbaker, E.; Strober, W.; Waldmann, T.A. Anaphylactic reactions to IgA: A difficult transfusion problem. Am. J. Clin. Pathol. 1970, 54, 618–621. [Google Scholar] [CrossRef] [PubMed]
- Webb, C.; Norris, A.; Hands, K. An acute transfusion reaction. Clin. Med. 2018, 18, 95–97. [Google Scholar] [CrossRef] [PubMed]
- Gilstad, C.W. Anaphylactic transfusion reactions. Curr. Opin. Hematol. 2003, 10, 419–423. [Google Scholar] [CrossRef] [PubMed]
- Ackfeld, T.; Schmutz, T.; Guechi, Y.; Le Terrier, C. Blood Transfusion Reactions-A Comprehensive Review of the Literature including a Swiss Perspective. J. Clin. Med. 2022, 11, 2859. [Google Scholar] [CrossRef] [PubMed]
- Cardigan, R.; New, H.V.; Tinegate, H.; Thomas, S. Washed Red Cells: Theory and Practice. Vox Sang. 2020, 115, 606–616. [Google Scholar] [CrossRef] [PubMed]
- O’Brien, S. Surveillance Report 2019; Canadian Blood Services: Ottawa, ON, Canada, 2019; Available online: https://professionaleducation.blood.ca/en/transfusion/publications/surveillance-report (accessed on 25 August 2023).
- TRIP Foundation. Trip Report 2018, Hemovigilance-Extended Version. 2018, p. 40. Available online: https://www.tripnet.nl/wpcontent/uploads/2020/08/Trip.HEMO_uitgebreid_ENGdef2020-4.pdf (accessed on 1 April 2023).
- Serious Hazards of transfusion (SHOT). Annual SHOT Report Serious Hazards of Transfusion Report 2020; Serious Hazards of transfusion (SHOT): Manchester, UK, 2020. [Google Scholar]
- Serious Hazards of transfusion (SHOT). Annual SHOT Report Serious Hazards of Transfusion Report 2022; Serious Hazards of transfusion (SHOT): Manchester, UK, 2022. [Google Scholar]
- Anani, W.; Triulzi, D.; Yazer, M.H.; Qu, L. Relative IgA-deficient recipients have an increased risk of severe allergic transfusion reactions. Vox Sang. 2014, 107, 389–392. [Google Scholar] [CrossRef] [PubMed]
- Soutar, R.; McSporran, W.; Tomlinson, T.; Booth, C.; Grey, S. Guideline on the investigation and management of acute transfusion reactions. Br. J. Haematol. 2023, 201, 832–844. [Google Scholar] [CrossRef] [PubMed]
Blood Components | IgA < 7 mg/dL n = 21 | IgA 7–60 mg/dL n = 10 |
---|---|---|
Red blood cells | 5 (1–56) | 19 (2–43) |
Fresh frozen plasma | 3.5 (1–21) | 4 (1–12) |
Platelet concentrates | 7.5 (1–65) | 10.5 (1–27) |
Signs and Symptoms | Mild AATRs (n = 614) | Severe AATRs (n = 56) |
---|---|---|
Pruritus | 307 | 16 |
Urticaria | 193 | 9 |
Skin rash | 331 | 25 |
Nausea/vomiting | 60 | 13 |
Fever | 70 | 0 |
Dyspnea | 61 | 31 |
Angio-edema | 9 | 4 |
Bronchospasm | 9 | 10 |
Shock | 0 | 9 |
Hypotension | 25 | 20 |
Blood component | ||
Platelet concentrate | 350 | 30 |
Fresh frozen plasma | 129 | 16 |
Red blood cells | 116 | 4 |
Hematopoietic progenitors | 16 | 4 |
Not reported | 3 | 2 |
Treatment | ||
Antihistamines | 122 | 1 |
Corticosteroids | 36 | 7 |
Antihistamines + steroids | 296 | 30 |
Acetaminophen | 19 | 0 |
Antihistamines + steroids + pethidine | 4 | 5 |
Pethidine | 8 | 0 |
Adrenalin | 0 | 6 |
Not reported | 129 | 6 |
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Solves, P.; Bataller, A.; Gálvez, A.B.; Asensi Cantó, P.; Santiago, M.; Moreno, M.J.; Gómez-Seguí, I.; de la Rubia, J. Selective IgA Deficiency and Blood Component Transfusion: In Search of the Lost Evidence. Hemato 2024, 5, 109-114. https://doi.org/10.3390/hemato5020009
Solves P, Bataller A, Gálvez AB, Asensi Cantó P, Santiago M, Moreno MJ, Gómez-Seguí I, de la Rubia J. Selective IgA Deficiency and Blood Component Transfusion: In Search of the Lost Evidence. Hemato. 2024; 5(2):109-114. https://doi.org/10.3390/hemato5020009
Chicago/Turabian StyleSolves, Pilar, Ana Bataller, Ana Belén Gálvez, Pedro Asensi Cantó, Marta Santiago, María José Moreno, Inés Gómez-Seguí, and Javier de la Rubia. 2024. "Selective IgA Deficiency and Blood Component Transfusion: In Search of the Lost Evidence" Hemato 5, no. 2: 109-114. https://doi.org/10.3390/hemato5020009