SLOWLY PROGRESSIVE LUNG INJURY AFTER BLOOD TRANSFUSION: ASSOCIATION WITH BLOOD TRANSFUSION

Abstract

An 82-year-old female was admitted to our hospital for treatment of a fracture of the femur. She demonstrated anemia and received red cell transfusion before and after surgery. Mild hypoxia was noted after the second red cell transfusion. At 72 hr after the first red cell transfusion (45 hr after the second), she developed marked hypoxia. She also complained of transient mild chest discomfort, but no clinical symptoms were reported at the time the marked hypoxia occurred. Bilateral pleural effusion and pulmonary edema were found on chest roentgenography. Acute myocardial infarction, cardiac failure, and pulmonary embolism were excluded by blood examination, ultrasonic cardiography, electrocardiography, and pulmonary perfusion scintigraphy, respectively ; however, hypoalbuminemia was found. She was administered oxygen, diuretics, and human serum albumin, after which pleural effusion, pulmonary edema, and hypoxia were resolved. Antigranulocyte antibodies or anti-HLA antibodies were not detected in sera from donors or recipient. The clinical features of this case were similar to those of transfusion-related acute lung injury, but, the course was slowly progressive.