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Transfusion-related acute lung injury/transfusion-associated circulatory overload in a child with non-transfusion dependent thalassemia and aplastic crisis due to acute parvovirus B19 infection
  1. Elpis Mantadakis1,
  2. Angeliki Vittoraki2,
  3. Alexandra Siorenta2 and
  4. Eftychia Kontekaki3
  1. 1Department of Pediatrics, Democritus University of Thrace, Faculty of Medicine, Alexandroupolis, Thrace, Greece
  2. 2Department of Immunology and National Tissue Typing Center, G. Gennimatas General Hospital of Athens, Athens, Attika, Greece
  3. 3Blood Transfusion Center, University General Hospital of Alexandroupolis, Alexandroupolis, Thrace, Greece
  1. Correspondence to Professor Elpis Mantadakis; emantada{at}med.duth.gr

Abstract

We present a never-transfused girl with thalassemia intermedia who was admitted for febrile aplastic crisis due to human parvovirus B19. After a first transfusion of packed red blood cells, she developed pulmonary oedema. She improved with supportive care including the use of intravenous diuretics. Due to severe anaemia, she received a second blood transfusion, antibiotics for febrile neutropenia and intravenous γ globulin for control of the parvovirus infection. She had an uneventful recovery. The first of her male blood donors had an antibody against a patient’s human leukocyte antigens type II antigen with a high mean fluorescent intensity. Our patient had clinical features and supportive laboratory evidence for mild transfusion-related acute lung injury (TRALI). However, she also met the criteria for transfusion-associated circulatory overload (TACO). We conclude that our patient likely suffered from TRALI/TACO, a consensus term proposed in 2019 for patients in whom TRALI cannot be distinguished from TACO or in whom both conditions occur simultaneously.

  • Haematology (drugs and medicines)
  • Paediatrics (drugs and medicines)

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: EM, AV, AS and EK. The following author gave final approval of the manuscript: EM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.