Delayed serum sickness-like transfusion reactions in a multiply transfused patient

The clinical features and progress of a patient with a fatal myeloproliferative disease are reported. Her care required frequent transfusions of red cell products and components. These transfusions were followed, after varying intervals, by fever, arthralgia, myalgia, headache and pericarditis. These reactions could be avoided by transfusing plasma-free products, and were ameliorated by systemic steroids. This patient, then, is the first reported case of delayed, serum sickness-like transfusion reactions. During the course of her illness she was demonstrated to have antibodies to immunoglobulins. The role of these antibodies, if any, is uncertain.