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Adverse Occurrence type:
In this Commentary, the estimated incidence of anaphylactic reactions following RBC transfusion estimated at 1 per 50,000. Evidence against a causative role for anti-IgA is the thesis of this publication---American Red Cross National Reference Laboratory data: only 17% of recipients with IgA deficiency have anti IgA; Canadian Blood Services data: no cases with absent IgA or anti-IgA among 43 cases of transfusion-related anaphylactic reactions.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Severe allergic reaction with respiratory involvement (i.e., wheezing, dyspnea) including 11 fatalities. Only 17% found to be IgA deficient (IgA deficiency defined as <0.05 mg/dL).
Demonstration of imputability or root cause:
This Commentary questions the validity of the entity IgA deficiency associated anaphylaxis.
The entity of immunoglobulin A–related anaphylactic transfusions reaction is not evidence based. Sandler SG et al. Transfusion. 2015 Jan;55(1):199-204
Interest for those concerned about pathogenesis of anaphylactic reactions.. Provides some evidence about choice of blood products for those suffering anaphylactic reactions requiring further transfusions.
Expert comments for publication:
Commentary providing information about an infrequent transfusion associated adverse event. The publication posts that anaphylactic reactions are unlikely related to IgA deficiency. This is an important concept.