Relative IgA‐deficient recipients have an increased risk of severe allergic transfusion reactions

Anani, Waseem Q.; Triulzi, Darrell J.; Yazer, Mark H.; Qu, Lirong

doi:10.1111/vox.12192

Cited by 17 publications

(11 citation statements)

References 17 publications

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“…Headache, chills, fever, and myalgia are the most common adverse reactions, usually mild in intensity [ 11 ]. Severe complications are rare and include acute renal failure, mainly associated with sucrose when used as a stabilizer [ 12 ], haemolysis caused by the presence of red blood cell IgG alloantibodies in Ig preparations [ 13 ], thromboembolic events mainly due to the increased blood viscosity early after Ig administration and/or the presence of pro-coagulant contaminants in Ig preparations [ 14 ], and severe allergic reactions, particularly in IgA-deficient patients [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

A Multicentre Study on the Efficacy, Safety and Pharmacokinetics of IqYmune®, a Highly Purified 10% Liquid Intravenous Immunoglobulin, in Patients with Primary Immune Deficiency

et al. 2017

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This multicentre, open-label, prospective, single-arm study was designed to evaluate the efficacy, pharmacokinetics, and safety of IqYmune®, a highly purified 10% polyvalent immunoglobulin preparation for intravenous administration in patients with primary immunodeficiency. IqYmune® was administered to 62 patients (aged 2–61 years) with X-linked agammaglobulinemia or common variable immune deficiency at a dose from 0.22 to 0.97 g/kg every 3 to 4 weeks for 12 months with an infusion rate up to 8 mL/kg/h. A pharmacokinetic study was performed at steady state between the 8th and the 9th infusion. A single case of serious bacterial infection was observed, leading to an annualized rate of serious bacterial infections/patient (primary endpoint) of 0.017 (98% CI: 0.000, 0.115). Overall, 228 infections were reported, most frequently bronchitis, chronic sinusitis, nasopharyngitis and upper respiratory tract infection. The mean annualized rate of infections was 3.79/patient. A lower risk of infections was associated with an IgG trough level > 8 g/L (p = 0.01). The mean annualized durations of absence from work or school and of hospitalization due to infections were 1.01 and 0.89 days/patient, respectively. The mean serum IgG trough level before the 6th infusion was 7.73 g/L after a mean dose of IqYmune® of 0.57 g/kg. The pharmacokinetic profile of IqYmune® was consistent with that of other intravenous immunoglobulins. Overall, 15.5% of infusions were associated with an adverse event occurring within 72 h post infusion. Headache was the most common adverse event. In conclusion, IqYmune® was shown to be effective and well tolerated in patients with primary immunodeficiency.

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Section: Introductionmentioning

confidence: 99%

A Multicentre Study on the Efficacy, Safety and Pharmacokinetics of IqYmune®, a Highly Purified 10% Liquid Intravenous Immunoglobulin, in Patients with Primary Immune Deficiency

et al. 2017

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“…The selective IgA deficiency (SIgAD) is the most common immunoglobulin deficiency. The prevalence of SIgAD differs depending on the ethnic origin and clinical symptoms of investigated persons [6][7][8]. The incidence of SIgAD varies significantly in different areas in Table 2 [15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Levels of Serum IgA in Healthy Blood Donors.

Arslan

Doğan

Baykan

et al. 2015

Glob. J. Immunol. Allerg. Dis.

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Objectives: We evaluate that the prevalence of immunoglobulin A deficiency in Turkish blood donors. The most of authors describe an IgA concentration of<5 mg/dL 1 as IgA deficiency and has been broadly studied in different ethnic groups. The patients with IgA deficiency may form specific antibodies against IgA. The antibodies against IgA can cause an anaphylactic response when the patient receives an IgA-containing blood transfusion. Methods: The blood samples were taken after blood donation. These serum samples stored at-20ºC until analysis. The amount of serum IgA was measured using the Dade Behring assay with automated Dade Behring Nephelometer (Dade Behring Marburg GmbH, Marburg, Germany). Results: Of the total 1077 healthy blood donors screened, none of the donors was found to be selective IgA deficiency. Conclusion: The incidence of IgA deficiency in Turkish blood donors is very low. But, anaphylaxis risks exist in performing blood transfusion to IgA-deficient individual, and measures should be taken to reduce IgA anaphylaxis.

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“…The biologic mechanism associated with this remains largely unknown, but patients who have had a transfusion-associated adverse reaction may have had an underlying immunodeficiency [ 50 ]. Particularly in cases transfused with blood products containing plasma, the development of anaphylaxis, a severe form of hypersensitivity, is highly associated with IgA deficiency, which appears from the production of Ig E Ab against Ig A [ 51 ].…”

Section: Risk Of Rbc Transfusionmentioning

confidence: 99%

Perioperative red blood cell transfusion in orofacial surgery

Park

Seo

Karm

2017

J Dent Anesth Pain Med

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In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

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Relative IgA‐deficient recipients have an increased risk of severe allergic transfusion reactions

Abstract: The significantly increased risk of SALTRs in relative IgA-deficient patients warrants consideration of premedications and/or washing of plasma-containing blood products.

Cited by 17 publications

References 17 publications

A Multicentre Study on the Efficacy, Safety and Pharmacokinetics of IqYmune®, a Highly Purified 10% Liquid Intravenous Immunoglobulin, in Patients with Primary Immune Deficiency

A Multicentre Study on the Efficacy, Safety and Pharmacokinetics of IqYmune®, a Highly Purified 10% Liquid Intravenous Immunoglobulin, in Patients with Primary Immune Deficiency

Levels of Serum IgA in Healthy Blood Donors.

Perioperative red blood cell transfusion in orofacial surgery

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