Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Two Cases of Transfusion Related Acute Lung Injury

수혈로 유발된 급성 폐 손상 2예

  • Lee, Kyoung Ju (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Hye Ok (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Jung Ha (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Ha, Eun Sil (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Jung, Jin Yong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Seung Hyeun (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Se Joong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Ju, Moon Kyung (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Eun Joo (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kang, Eun Hae (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Jung, Ki Hwan (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Sung Yong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Lee, Sang Yeub (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kim, Je Hyeong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Shin, Chol (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Shim, Jae Jeong (Department of Internal Medicine, College of Medicine, Korea University) ;
  • In, Kwang Ho (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Kang, Kyung Ho (Department of Internal Medicine, College of Medicine, Korea University) ;
  • Yoo, Se Hwa (Department of Internal Medicine, College of Medicine, Korea University)
  • 이경주 (고려대학교 의과대학 내과학교실) ;
  • 김혜옥 (고려대학교 의과대학 내과학교실) ;
  • 김정하 (고려대학교 의과대학 내과학교실) ;
  • 하은실 (고려대학교 의과대학 내과학교실) ;
  • 정진용 (고려대학교 의과대학 내과학교실) ;
  • 이승현 (고려대학교 의과대학 내과학교실) ;
  • 김세중 (고려대학교 의과대학 내과학교실) ;
  • 주문경 (고려대학교 의과대학 내과학교실) ;
  • 이은주 (고려대학교 의과대학 내과학교실) ;
  • 강은해 (고려대학교 의과대학 내과학교실) ;
  • 정기환 (고려대학교 의과대학 내과학교실) ;
  • 이승룡 (고려대학교 의과대학 내과학교실) ;
  • 이상엽 (고려대학교 의과대학 내과학교실) ;
  • 김제형 (고려대학교 의과대학 내과학교실) ;
  • 신철 (고려대학교 의과대학 내과학교실) ;
  • 심재정 (고려대학교 의과대학 내과학교실) ;
  • 인광호 (고려대학교 의과대학 내과학교실) ;
  • 강경호 (고려대학교 의과대학 내과학교실) ;
  • 유세화 (고려대학교 의과대학 내과학교실)
  • Received : 2006.08.30
  • Accepted : 2006.10.17
  • Published : 2006.11.30
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Abstract

Transfusion related acute lung injury (TRALI) is a serious, potentially life-threatening complication of transfusion therapy that is sometimes under diagnosed and under reported. Patients with TRALI present with dyspnea/respiratory distress and fever. The symptoms, signs and chest radiological findings in TRALI are similar to transfusion associated circulatory overload, which makes it is difficult to distinguish it from circulatory overload. Although the mortality rate in cases of TRALI is relatively low, TRALI is the third most common cause of fatal transfusion reactions next to ABO blood type incompatibility and hepatitis. Mild-to-moderate cases of TRALI may be misdiagnosed as volume overload. Recently, we encountered two cases where the patients suffered from dyspnea and fever after a transfusion. and review of the relevant literature.

저자들은 폐암 및 항암치료에 의한 만성 질환으로 유발된 중등도의 빈혈이 있어 농축적혈구의 수혈치료 후 발생한 호흡곤란 및 발열 호소하여 다른 원인 감별 후 수혈에 의해 유발된 급성 폐 손상 진단하에 대증치료후 환자의 증상은 호전되었다. 이러한 수혈에 의해 유발된 급성 폐 손상은 그간 국내에서 보고 된 적이 없었던 증례로 이를 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Barnard RD. Indiscriminate transfusion: a critique of case reports illustrating hypersensitivity reactions. N Y State J Med 1951;51:2399-402
  2. Popovsky MA, Abel MD, Moore SB. Transfusionrelated acute lung injury associated with passive transfer of antileukocyte antibodies. Am Rev Respir Dis 1983;128:185-9 https://doi.org/10.1164/arrd.1983.128.1.185
  3. Bux J. Transfusion-related acute lung injury (TRALI): a serious adverse event of blood transfusion. Vox Sang 2005;89:1-10
  4. Kleinman S, Caulfield T, Chan P, Davenport R, Mc- Farland J, McPhedran S, et al. Toward an understanding of transfusion-related acute lung injury: statement of a consensus panel. Transfusion 2004;44: 1774-89 https://doi.org/10.1111/j.0041-1132.2004.04347.x
  5. Toy P, Popovsky MA, Abraham E, Ambruso DR, Holness LG, Kopko PM, et al. Transfusion-related acute lung injury: definition and review. Crit Care Med 2005;33:721-6 https://doi.org/10.1097/01.CCM.0000159849.94750.51
  6. Sazama K. Reports of 355 transfusion-associated deaths: 1976 through 1985. Transfusion 1990;30: 583-90 https://doi.org/10.1046/j.1537-2995.1990.30790385515.x
  7. Suassuna JH, da Costa MA, Faria RA, Melichar AC. Noncardiogenic pulmonary edematriggered by intravenous immunoglobulin in cancer-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Nephron 1997;77:368-70 https://doi.org/10.1159/000190309
  8. Wolf CF, Canale VC. Fatal pulmonary hypersensitivity reaction to HL-A incompatible blood transfusion: report of a case and review of the literature. Transfusion 1976;16:135-40 https://doi.org/10.1046/j.1537-2995.1976.16276155107.x
  9. Silliman CC, Dickey WO, Paterson AJ, Thurman GW, Clay KL, Johnson CA, et al. Analysis of the priming activity of lipids generated during routine storage of platelet concentrates. Transfusion 1996;36:133-9 https://doi.org/10.1046/j.1537-2995.1996.36296181925.x
  10. Gong MN, Wei Z, Xu LL, Miller DP, Thompson BT, Christiani DC. Polymorphism in the surfactant protein-B gene, gender, and the risk of direct pulmonary injury and ARDS. Chest 2004;125:203-11 https://doi.org/10.1378/chest.125.1.203
  11. Hudson LD, Milberg JA, Anardi D, Maunder RJ. Clinical risks for development of the acute respiratory distress syndrome. Am J Respir Crit Care Med 1995;151:293-301 https://doi.org/10.1164/ajrccm.151.2.7842182
  12. Pepe PE, Potkin RT, Reus DH, Hudson LD, Carrico CJ. Clinical predictors of the adult respiratory distress syndrome. Am J Surg 1982;144:124-30 https://doi.org/10.1016/0002-9610(82)90612-2
  13. Fein A, Grossman RF, Jones JG, Overland E, Pitts L, Murray JF, et al. The value of edema fluid protein measurement in patients with pulmonary edema. Am J Med 1979;67:32-8 https://doi.org/10.1016/0002-9343(79)90066-4
  14. Ausley MB Jr. Fatal transfusion reactions caused by donor antibodies to recipient leukocytes. Am J Forensic Med Pathol 1987;8:287-90 https://doi.org/10.1097/00000433-198712000-00004
  15. Brittingham TE. Immunologic studies on leukocytes. Vox Sang 1957;2:242-8 https://doi.org/10.1111/j.1423-0410.1957.tb03699.x