Fresh Frozen Plasma Transfusion Induced Anaphylactic Shock: A Case Report

Abstract

Introduction: The adverse transfusion reactions (ATRs) underlying the developments of transfusion severely disturbed transfusion therapy, which should deserve more attention from technologists. Case Presentation: One bag of Fresh Frozen Plasma (FFP) was implicated in one case of anaphylactic shock in a pediatric rhabdomyosarcoma (RMS) patient. The plasma from a donor and the pre-/post-transfused plasma from the patient was used to evaluate the immunoglobulin (Ig) A, IgE by serum immunoglobulin assay, and interleukin (IL) 2, IL-4, IL-6, IL-10, TNF and IFN-γ by flow cytometry. The IgE concentration in the plasma from the pre-transfused patient was 1980 IU/mL, which indicates that the patient was in a hyperallergenic state prior to FFP transfusion, and with a history of anaphylactic reaction induced by plasma transfusion and that coupled with continuous stimulation of plasma components induced the occurrence of anaphylactic shock. The IgE level increased to 3160 IU/mL when the shock occurred. The IL-6 and IL-10 were elevated from 218.7 pg/mL before transfusion to 284.1 pg/mL after transfusion and from 4.2 pg/mL to 15.8 pg/mL. Conclusions: The high concentration of IgE in the patient with a history of allergy before transfusion can induce severe ATRs, leading to the occurrence of anaphylactic shock, and although rare, it should not be ignored. These patients need management that is more advanced and examinations before plasma transfusion and more inspections during the transfusion process.