TRALI (Transfusion Related Acute Lung Injury)

Record number: 
1091
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
10 minutes
Alerting signals, symptoms, evidence of occurrence: 
A 77-year-old female with common variable immune deficiency had been receiving IVIG since 1996 for infection prophylaxis. Ten minutes after a scheduled infusion, the patient developed hypertension and dyspnea, requiring increasing oxygen supplementation and subsequent intubation. Radiographic studies demonstrated the bilateral chest infiltrates, with no evidence of infection. Findings of clinical examination, lack of response to trial of IV diuretic treatment and a normal BNP during the reaction make circulatory overload unlikely.
Demonstration of imputability or root cause: 
The patient had not previously received this batch of IVIG and has since received further transfusions with different lot numbers of the same product without incident. This case report documents a case of TRALI after IVIG transfusion. While a very rare cause this case furthers evidence that TRALI can occur after IVIG transfusion.
Suggest references: 
Quest, G.R., Gaal, H., Clarke,G. andNahirniak, S. (2014). Transfusion-related acute lung injury after transfusion of pooled immune globulin: a case report. Transfusion 54:3088-3091