A CASE OF TRANSFUSION REACTION ASSOCIATED WITH ANTI-IgA ANTIBODY

We report the case of a patient with systemic lupus erythematosus with selective IgA deficiency who developed anaphylactic transfusion reactions. A 50-year-old woman with systemic lupus erythematosus was suspected of having IgA deficiency due to IgA nondetection in the immunoglobulin test on admission, but the test for anti-IgA antibody was not performed. She was administered a platelet concentrate transfusion because of prolonged bleeding time after surgery. About 10min after starting transfusion, she developed palpitations, dyspnea, and hypotension, and went into shock. Anti-IgA antibody was detected from the patient's stored serum collected before the transfusion. It was suggested that IgA present in the transfused platelet concentrate may have induced the anaphylactic shock after reacting with the pre-existing anti-IgA antibody. To avoid unexpected anaphylactic transfusion reactions, attention should be paid to the presence of anti-IgA antibody in patients with selective IgA deficiency.