Moderate allergic (anaphylactoid) and severe allergic (anaphylactic) transfusion reaction

Moderate allergic (anaphylactoid) and severe allergic (anaphylactic) transfusion reaction

Updated: 07/28/2025

© Jun Wang, MD, PhD

 

General features

  • Uncommon generally
  • Commonly associated with IgA deficiency, haptoglobin deficiency, or other allergens presents in donor’s plasma (drugs, food components)
  • Very uncommon to identify a specific allergen
  • May cause hypotension, shock, etc 

Clinical presentations

  • Immediate onset
  • Usually no fever
  • Commonly airway obstruction beside urticaria (hives), angioedema, etc
  • Wheezing, chest tightness, dyspnea, etc
  • Presentations of hypotension, shock, etc 

Key pathogenesis

  • IgE mediated (type I hypersensitivity) reaction toward plasma protein in donor units
  • Activation of mast cells results in production of histamine and other cytokines

Management

  • Epinephrine
  • Other supportive managements

 

 

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