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Q&A column, 6/15

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Editor: Frederick L. Kiechle, MD, PhD

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Blood components for IgA-deficient patients

Measuring lactate concentrations

 

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Q. Can IgA-deficient patients who require transfusion receive blood only from donors who are also IgA deficient?

A. Patients who are IgA deficient and do not have a history of a prior anaphylactic transfusion reaction do not require IgA-deficient blood components. Most case reports of IgA-related anaphylactic transfusion reactions in the literature describe generalized reactions in patients with selective IgA deficiency (less than 0.05 mg/dL IgA) who also had anti-IgA in their plasma. Anaphylactic reactions may occur following transfusions of plasma in patients with or without IgA deficiency. A recent review of published cases of transfusion-related anaphylaxis, as well as more recent hemovigilance data, indicate that IgA deficiency with anti-IgA is rarely, if ever, an etiologic factor in transfusion-associated anaphylaxis.1

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