輸血穿刺部位に見られた激痛と発赤を伴った急性輸血反応-急性局所疼痛性輸血反応？

Abstract

Acute pain transfusion reaction (APTR) is a rare adverse event (AE), characterized by severe pain in the trunk and extremities accompanied by dyspnea, hypertension and chills soon after initiation of a transfusion. It disappears after stopping the transfusion. We experienced a case of severe pain and redness that was limited to the puncture sites.The patient had received a stent graft for acute aortic arch dissection six months before presentation. At our hospital he received another stent graft and underwent an artery bypass operation, in which autologous red blood cells (RBCs) were transfused without incident. On the following day, one bag of pre-storage leukocyte-reduced RBCs (PLR-RBCs) derived from 400 ml of whole blood was transfused. Immediately after initiating the transfusion, severe pain and redness at the puncture site occurred. The transfusion was stopped, and the symptoms disappeared approximately 10 minutes later. When the same blood was transfused into the opposite arm, similar symptoms with a temporary slight increase in blood pressure (BP) occurred and disappeared after stopping the transfusion. Hemolytic findings were not detected. Two more PLR-RBCs bags were thereafter administered without AEs. On the second day, when one PLR-RBCs bag was transfused, the same symptoms appeared and disappeared after stopping the transfusion.These AEs with severe pain and redness at the puncture sites without other symptoms except a temporary slight increase in BP, might be due to a form of acute localized pain transfusion reaction (ALPTR) distinct from APTR.