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Anaphylactic transfusion reaction associated with a possible anti-A2m(1)
Clinical and Laboratory Haematology
|January 1, 1983
Summary
A patient experienced a severe transfusion reaction due to an anti-A2m(1) antibody. Successful treatment involved using platelet concentrates from donors with a specific A2m(1) negative phenotype.
Area of Science:
- Immunology
- Transfusion Medicine
- Genetics
Background:
- Immunoglobulin A (IgA) is crucial for immune function.
- IgA subclasses, like IgA2, have genetic variants (allotypes) such as A2m(1) and A2m(2).
- Transfusion reactions can occur due to antibody formation against donor antigens.
Observation:
- A patient with leukemia developed anaphylaxis and cardiorespiratory arrest post-platelet transfusion.
- The patient had an antibody against denatured IgA2 protein with A2m(1+) phenotype.
- Platelet donors were A2m(1+) positive, while the patient was A2m(1-) negative.
Findings:
- The patient's antibody was identified as anti-A2m(1).
- This is the first reported case of a transfusion reaction solely due to anti-A2m(1).
- The patient's A2m(1-) phenotype is relatively common in certain ethnic groups (Blacks, Chinese).
Implications:
- Highlights the importance of considering IgA allotypes in transfusion reactions.
- Suggests a need for screening for anti-A2m antibodies in specific patient populations.
- Guides the selection of compatible platelet donors to prevent future adverse events.