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Background: Blood transfusion is a routine lifesaving medical intervention which is generally regarded as safe when done properly. However, at the same time it also bears considerable risk. The aim of the study was to assess the serum IgE levels in patients experiencing transfusion-related allergic reactions after receiving fresh frozen plasma. Methods: This cross-sectional observational study was conducted at the Department of Transfusion Medicine, BSMMU, from March 2019 to August 2021, focusing on patients aged 5 to 60 years receiving fresh frozen plasma. Patients were included after obtaining informed consent from themselves or their legal guardians in the case of minors, according to the eligibility criteria. Data were analyzed using SPSS version 26, with statistical significance set at p<0.05, employing Chi-square tests and Pearson抯 correlation coefficient for variable comparisons. Results: Raised IgE level was significantly related with transfusion related allergic reaction after receiving fresh frozen plasma (p<0.05). The mean IgE was 521.4�4.6 in patients with reaction and 67.8�.2 in patients without reaction. Significant positive correlation was observed in serum IgE level with age in years. Conclusions: Patients with transfusion related allergic reaction receiving fresh frozen plasma had higher mean IgE levels as compared to those without reaction.
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AIM: To evaluate the therapeutic effect of emedastine difumarate eye drops combined with fluorometholone eye drops on allergic conjunctivitis.METHODS: Retrospective study. A total of 115 patients(230 eyes)with allergic conjunctivitis who received treatment from June 2020 to August 2022 were selected, and they were divided into the observation group(56 cases, 112 eyes)and the control group(59 cases, 118 eyes)according to whether to use fluorometholone eye drops combined with the conventional use of emedastine difumarate eye drops. The clinical symptoms and signs, tear film break-up time(BUT), corneal fluorescein staining score and complications of the two groups were observed before treatment and at 4 wk after treatment.RESULTS: After treatment, the scores of eye symptoms and signs in the two groups were decreased, and the observation group was lower than the control group(P<0.05); BUT of the two groups was longer than that before treatment, and the observation group was longer than that of the control group(P<0.05); The corneal fluorescein staining scores of the two groups decreased, and those of the observation group were lower than those of the control group(P<0.05); There was no significant difference in the total incidence of complications between the two groups after treatment(3.6% vs 5.1%; P>0.05).CONCLUSION: With high therapeutic safety and effectiveness, the combination of emedastine difumarate eye drops and fluorometholone eye drops in the treatment of allergic conjunctivitis can significantly reduce the patient's symptom and sign scores, prolong BUT, promote a decrease in corneal fluorescein staining scores, improve efficacy, and do not increase the risk of complications.
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Protein as the allergens could lead to allergy. In addition, a widespread class of allergens were known as glycans of N-glycoprotein. N-glycoprotein contained oligosaccharide linked by covalent bonds with protein. Recently,studies implicated that allergy was associated with glycans of heterologous N-glycoprotein found in food, inhalants, insect toxins, etc. The N-glycan structure of N-glycoprotein allergen has exerted an influence on the binding between allergens and IgE, while the recognition and presentation of allergens by antigen-presenting cells (APCs) were also affected. Some researches showed thatN-glycan structure of allergen was remodeled by N-glycosidase, such as cFase I, gpcXylase, as binding of allergen and IgE partly decreased. Thus, allergic problems caused by N-glycoproteins could potentially be solved by modifying or altering the structure ofN-glycoprotein allergens, addressing the root of the issue. Mechanism of N-glycans associated allergy could also be elaborated through glycosylation enzymes, alterations of host glycosylation. This article hopes to provide a separate insight for glycoimmunology perspective, and an alternative strategy for clinical prevention or therapy of allergic diseases.
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Based on the strategy of metabolomics combined with bioinformatics, this study analyzed the potential allergens and mechanism of pseudo-allergic reactions (PARs) induced by the combined use of Reduning injection and penicillin G injection. All animal experiments and welfare are in accordance with the requirements of the First Affiliated Experimental Animal Ethics and Animal Welfare Committee of Henan University of Chinese Medicine (approval number: YFYDW2020002). Based on UPLC-Q-TOF/MS technology combined with UNIFI software, a total of 21 compounds were identified in Reduning and penicillin G mixed injection. Based on molecular docking technology, 10 potential allergens with strong binding activity to MrgprX2 agonist sites were further screened. Metabolomics analysis using UPLC-Q-TOF/MS technology revealed that 34 differential metabolites such as arachidonic acid, phosphatidylcholine, phosphatidylserine, prostaglandins, and leukotrienes were endogenous differential metabolites of PARs caused by combined use of Reduning injection and penicillin G injection. Through the analysis of the "potential allergen-target-endogenous differential metabolite" interaction network, the chlorogenic acids (such as chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid, and isochlorogenic acid A) and β-lactam allergens in the combination of the two may be mainly regulated by PLD1, PLA2G12A and CYP1A1. The three upstream signal target proteins mainly activate the arachidonic acid metabolic pathway, promote the degranulation of mast cells, release downstream endogenous inflammatory mediators, and induce PARs.
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Objective To study the distribution and clinical significance of allergens in children with adenoid hypertrophy.Methods The allergen detection results of 223 children with adenoid hypertrophy admitted to the Department of Otolaryngology,the Wuxi Second People's Hospital from January 2021 to October 2022 were retrospectively analyzed,while 43 children without adenoid hypertrophy were set as the control group.The allergy test results were compared between the two groups for difference.Results The positive rate of total allergens in adenoid hypertrophy group was 54.7%.The positive rate of total allergens in the control group was 27.9%.The difference was statistically significant(P<0.05).In the adenoid hypertrophy group,the positive rate of inhaled allergens was 41.3%,mainly mites/dusts and molds.The positive rate of ingested allergens was 32.3%,mainly milk and egg white.The adenoid hypertrophy group was divided according to age.The positive rate of total allergens was 54.0%in the 2-7 year old group.The positive rate of total allergens in the 8-14 year old group was 55.7%.There was no significant difference between the two groups(P>0.05).Conclusion Allergen stimulation is one of the causes of adenoid hypertrophy.Mite,mold,milk and egg white are common allergens in children with adenoid hypertrophy in Wuxi.The effect of allergen stimulation on adenoid hypertrophy did not decrease with age.Therefore,the detection of serum allergens can help to understand the specific allergens of children and provide direction for the non-surgical treatment of children with adenoid hypertrophy.
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La alergia a las proteínas de la leche de vaca aparece en los primeros meses de vida y es la alergia alimentaria más frecuente en el lactante y el niño pequeño. Esta investigación tiene como objetivo caracterizar clínica y epidemiológicamente a pacientes con alergia a las proteínas de la leche de vaca. Se realizó un estudio longitudinal, descriptivo, retrospectivo en el hospital infantil Hermanos Cordové del municipio Manzanillo en Granma, Cuba. La población estuvo constituida por los 10 infantes egresados de la institución durante el período 2017-2021. Se estudiaron las variables: edad, sexo, estadía, tiempo de evolución de la enfermedad, lactancia, factores de riesgo, evaluación nutricional. Entre los principales resultados se obtuvieron que predominó el sexo femenino y las edades de uno a seis meses (60 %). El 50 % de niños estaban desnutridos. El 70 % de los pacientes presentaron diarreas como principal síntoma, seguido por las lesiones de piel (60 %). Solo el 20 % recibieron lactancia materna exclusiva hasta los 6 meses de edad. El parto por cesárea fue el factor de riesgo más predominante (50 %). Se concluye que el sexo femenino y las edades de uno a seis meses fueron las más sobresalientes. La diarrea y las lesiones de piel fueron las manifestaciones clínicas más frecuentes de los pacientes con alergia a las proteínas de la leche de vaca. Los lactantes desnutridos, con lactancia artificial y antecedentes de parto por cesárea tienen mayores probabilidades de padecer esta enfermedad.
Allergy to cow's milk proteins, appears in the first months of life and is the most common food allergy in infants and young children. This research aims to characterize clinically and epidemiologically patients with allergy to cow's milk proteins. A longitudinal, descriptive, retrospective study was conducted at the Hermanos Cordové Children's Hospital in the municipality of Manzanillo in Granma, Cuba. The population consisted of the 10 children who graduated from the institution during the period 2017-2021. The following variables were studied: age, sex, length of stay, duration of disease progression, breastfeeding, risk factors, nutritional assessment. Among the main results, it was found that the female sex and the ages of one to six months predominated (60 %). The 50 % of children were malnourished. 70 % of patients had diarrhea as the main symptom, followed by skin lesions (60 %). Only 20 % were exclusively breastfed up to 6 months of age. Caesarean section was the most prevalent risk factor (50 %). It is concluded that the female sex and the ages of one to six months were the most outstanding. Diarrhea and skin lesions were the most common clinical manifestations in patients with cow's milk protein allergy. Malnourished infants, breastfed infants and a history of cesarean delivery are more likely to have this disease.
A alergia à proteína do leite de vaca aparece nos primeiros meses de vida e é a alergia alimentar mais comum em lactentes e crianças pequenas. Esta pesquisa tem como objetivo caracterizar clínica e epidemiologicamente pacientes com alergia à proteína do leite de vaca. Foi realizado um estudo longitudinal, descritivo e retrospectivo no Hospital Infantil Hermanos Cordové, no município de Manzanillo, em Granma, Cuba. A população foi composta por 10 crianças que se formaram na instituição no período de 2017 a 2021. As seguintes variáveis foram estudadas: idade, sexo, tempo de internação, tempo de evolução da doença, aleitamento materno, fatores de risco, avaliação nutricional. Dentre os principais resultados, predominaram o sexo feminino e a faixa etária de um a seis meses (60%). 50% das crianças estavam desnutridas. A diarreia foi o principal sintoma de 70% dos pacientes, seguida pelas lesões cutâneas (60%). Apenas 20% foram amamentados exclusivamente até os 6 meses de idade. O parto cesáreo foi o fator de risco mais prevalente (50%). Conclui-se que o sexo feminino e a idade de um a seis meses foram os que mais se destacaram. Diarreia e lesões cutâneas foram as manifestações clínicas mais frequentes dos pacientes com alergia à proteína do leite de vaca. Lactentes desnutridos, lactentes com alimentação com fórmula e história de parto cesáreo são mais propensos a sofrer dessa doença.
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【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.
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Vaccination has been proved to be the most effective strategy to prevent the Corona Virus Disease 2019 (COVID-19). The mRNA vaccine based on nano drug delivery system (NDDS) - lipid nanoparticles (LNP) has been widely used because of its high effectiveness and safety. Although there have been reports of severe allergic reactions caused by mRNA-LNP vaccines, the mechanism and components of anaphylaxis have not been completely clarified yet. This review focuses on two mRNA-LNP vaccines, BNT162b2 and mRNA-1273. After summarizing the structural characteristics, potential allergens, possible allergic reaction mechanism, and pharmacokinetics of mRNA and LNP in vivo, this article then reviews the evaluation methods for patients with allergic history, as well as the regulations of different countries and regions on people who should not be vaccinated, in order to promote more safe injection of vaccines. LNP has become a recognized highly customizable nucleic acid delivery vector, which not only shows its value in mRNA vaccines, but also has great potential in treating rare diseases, cancers and other broad fields in the future. At the moment when mRNA-LNP vaccines open a new era of nano medicine, it is expected to provide some inspiration for safety research in the process of research, development and evaluation of more nano delivery drugs, and promote more nano drugs successfully to market.
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Objective To investigate the clinical features of patients with allergic reactions induced by hepatic arterial perfusion chemotherapy,and to discuss its nursing strategy.Methods The clinical manifestations,severity grading,time of onset,high-risk drugs,and the initial symptom of anaphylactic shock in 82 patients with allergic reactions were analyzed.Results Of the 82 patients,57(69.5%)had liver metastases from colorectal cancer,aged 42-82 years.Most patients(98.8%)were allergic to oxaliplatin.Degree I allergic reaction was most commonly seen(80.5%),and the clinical manifestations were mainly skin symptoms.Multiple symptoms could occur at the same time.The allergic reactions could occur in various time periods of medication,and anaphylactic shock usually occurred within 30 min after medication,and the initial symptom was atypical.Conclusion Oxaliplatin is a common drug that may cause allergic reactions in patients receiving hepatic artery infusion chemotherapy.Nursing staff should be familiar with the relevant drug allergic reactions,especially the clinical symptoms,features,and nursing measures of anaphylactic shock,so as to ensure the safety of patients.(J Intervent Radiol,2023,32:1242-1245)
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Objetivo: investigar o rastreamento da hipersensibilidade metálica realizada pelos profissionais e estudantes de saúde durante a prática clínico-cirúrgico. Método: estudo exploratório-descritivo realizado com 228 profissionais e estudantes da área da saúde, por meio de questionário eletrônico semiestruturado, aplicado durante abril e maio de 2021, analisado por meio da estatística descritiva e da frequência de palavras. Resultados: 11,0% dos participantes realizaram a investigação sobre a hipersensibilidade metálica. 67,1% declararam que muito provavelmente poderiam incluir essa temática durante a triagem em seus atendimentos. Falta de conhecimento sobre alergia a metais e causas multifatoriais durante a prática clínico-cirúrgica foram citadas como barreiras para a implementação do rastreamento da hipersensibilidade metálica. Conclusão: pouco se evidencia o rastreamento da hipersensibilidade metálica em pacientes durante a prática clínico-cirúrgica dos profissionais e estudantes de saúde.
Objetivo: investigar el rastreo de la hipersensibilidad metálica realizada por los profesionales y estudiantes de salud durante la práctica clínico-quirúrgica. Método: estudio exploratorio-descriptivo realizado con 228 profesionales y estudiantes del área de la salud, por medio de cuestionario electrónico semiestructurado, aplicado durante abril y mayo de 2021, analizado por medio de la estadística descriptiva y de la frecuencia de palabras. Resultados: 11,0% de los participantes realizaron la investigación sobre la hipersensibilidad metálica. El 67,1% declaró que muy probablemente podrían incluir esa temática durante la selección en sus atenciones. La falta de conocimientos sobre la alergia a los metales y las causas multifactoriales durante la práctica clínico-quirúrgica se citaron como barreras para la implementación del seguimiento de la hipersensibilidad metálica. Conclusión: poco se evidencia el rastreo de la hipersensibilidad metálica en pacientes durante la práctica clínico-quirúrgica de los profesionales y estudiantes de salud.
Objective to investigate the screening of metallic hypersensitivity performed by health professionals and students during clinical-surgical practice. Method: an exploratory-descriptive study conducted with 228 health professionals and students, through a semi-structured electronic questionnaire, applied during April and May 2021, analyzed through descriptive statistics and the frequency of words. Results: 11.0% of participants conducted research on metallic hypersensitivity. 67.1% stated that they could very likely include this theme during screening in their care. Lack of knowledge about metal allergy and multifactorial causes during clinical-surgical practice were cited as barriers to the implementation of metallic hypersensitivity screening. Conclusion: there is little evidence of metallic hypersensitivity screening in patients during the clinical-surgical practice of health professionals and students.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cirurgia Geral/instrumentação , Hipersensibilidade/prevenção & controle , Metais/efeitos adversos , Equipe de Assistência ao Paciente , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
【Objective】 To investigate the incidence and composition of adverse reactions to blood transfusion(ARBT) in Qingdao hospitals in recent years. 【Methods】 The "Statistical Table of Adverse Reactions to Blood Transfusion in Medical Institutions" issued by Qingdao Quality Control Center of Blood Transfusion throughout 2020 to 2021, involving 96 hospitals in the region, were collected and analyzed, including the number, proportion and types of ARBT, as well as the types of blood components transfused. 【Results】 From 2020 to 2021, 296 676 cases of blood transfusion in 96 hospitals occurred, and the incidence of ARBT was 0.27% (814/296 676), of which the incidence of ARBT involving plasma transfusion was 0.17% [accounting for 39.07% (318/814) of all transfusion reactions], involving platelet transfusion was 0.68% [31.08% (259/814)], involving erythrocyte transfusion was 0.11% [27.64% (225/814)] and cryoprecipitation transfusion 0.03% [1.47% (12/814)]. The types of ARBT were anaphylaxis 77.64% (632/814), fever 19.78% (161/814), transfusion-related dyspnea 1.47% (12/814), transfusion-related circulatory overload 0.37% (3/814), purpura 0.25% (2/814) and transfusion-related hypotension 0.25% (2/814), delayed hemolysis 0.12%(1/814) and acute hemolysis 0.12%(1/814), respectively. 【Conclusion】 In recent years, the incidence of ARBT in local medical institutions is lower than that of domestic general level, and the main reactions are anaphylaxis and fever following the transfusion of plasma or (and) platelets.The monitoring and control of ARBT should be strengthened in each hospital with accurate and timely report, and active preventive measures should be taken to control or reduce the incidence of ARBT effectively.
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Aim To explore the establishment of BN rat animal model and RBL-2H3 cell model of allergic reaction to Yinzhihuang injection. Methods ASA test was performed to compare the symptoms and grades of allergic reactions in BN rats and Hartley guinea pigs, and serum IgE and histamine levels were detected. The amount of histamine released from RBL-2H3 cell supernatant was measured after Yinzhihuang injection affected, and the intracellular Ca
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Abstract Tattooing one's body is currently a common practice worldwide; however, it is not risk-free. This is a case of a patient who tattooed himself motivated by his passion for motorcycles and then developed an exuberant lichenoid reaction to the red pigment used in the tattoo, with the appearance of verrucous lesions. Despite the lack of response to treatment, he states that he would tattoo his own skin again.
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Humanos , Masculino , Tatuagem/efeitos adversos , Erupções Liquenoides/induzido quimicamente , Pele , Motocicletas , CorantesRESUMO
Allergic reactions are host immune responses to endogenous or exogenous antigens, which can result in local and systemic problems. Among the main allergens are the dental materials used in orthodontics, which faces some challenges with regard to biocompatibility with oral tissues.This study aimed to analyze in the literature which materials used in orthodontics are related to the appearance of oral and perioral allergic reactions, as well as to investigate the most prevalen t manifestations.An integrative review was carried out with articles published between 2010 and 2020 on the PubMed, Embase, and ScienceDirect on-line database. For this, MeSH descriptors and synonyms were used following two semantic fields: "Hypersensitivity" in association with "Orthodontic Appliances", the selection of studies counted with the stages of identifica tion, screening, eligibility and inclusion. Randomized clinical trials, cross-sectional or cohort clinical trials; Patients with alle rgic reactions affecting the oral or perioral region due to contact with orthodontic material, were included in the review.From a to tal of 549 articles only 04 were selected for the study. In accordance with what has been analyzed in the evidence of these studies, periodontal changes such as gingival inflammation as well as erythema, edema, papules and blisters were the main reactions described. Furthermore, in all articles there was an association with nickel and in only one with chromium. It is possible to i nfer that inflammatory lesions are frequent manifestations on the use of nickel in orthodontic patients.
Las reacciones alérgicas son respuestas inmunes del huésped a antígenos endógenos o exógenos, los cuales pueden provocar problemas locales y sistémicos. Entre los principales alérgenos se encuentran los materiales dentales utilizados en la ortodoncia, la cual se enfrenta a algunos desafíos respecto a la biocompatibilidad de los tejidos orales. Este estudio tuvo como objetivo analizar en la literatura que materiales utilizados en ortodoncia están relacionados con la aparición de reacciones alérgicas orales y periorales, así como investigar las manifestaciones más prevalentes. Se llevó a cabo una revisión con artículos publicados entre 2010 y 2020 en las bases de datos PubMed, Embase y ScienceDirect. Para ello, se utilizaron descriptores y sinónimos de MeSH siguiendo dos campos semánticos: "Hipersensibilidad" en asociación con "Aparatos de Ortodoncia", la selección de estudios contó con las etapas de identificación, cribado, elegibilidad e inclusión. Ensayos clínicos aleatorizados, ensayos clínicos transversales o de cohortes; en la revisión se incluyeron pacientes con reacciones alérgicas que afectaron a la regiones oral o perioral debido al contacto con material de ortodoncia. De un total de 549 artículos sólo cuatro fueron seleccionados para el estudio. De acuerdo con lo que se analizó en la evidencia, las principales reacciones descritas fueron cambios periodontales, como inflamación gingival, eritema, edema, pápulas y ampollas. Además, en todos los artículos hubo una asociación con níquel y solamente en uno con cromo. Es posible inferir que las lesiones inflamatorias son manifestaciones frecuentes sobre el uso de níquel en pacientes de ortodoncia.
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Humanos , Queilite/induzido quimicamente , Dermatite de Contato , Hipersensibilidade/epidemiologia , Ortodontia , Materiais Biomédicos e Odontológicos , Níquel/efeitos adversosRESUMO
Objective:To discuss the safety of oral food challenge test(OFC).Methods:Clinical data of 120 cases with allergic reactions during OFC in Department of Pediatrics, Peking University Third Hospital from October 2015 to October 2019 were retrospectively analyzed.The relationship between sex, type of allergic foods, type of allergic reactions, involved organ system, serum specific IgE and severe allergic reaction were analyzed.Results:Allergic reactions occurred in 120 cases.There were 95 males and 25 females.The age ranged from 2 months to 10 years.All involved allergens included milk protein(47.5%, 57/120 cases), egg white(22.5%, 27/120 cases), wheat(19.2%, 23/120 cases), peanut(6.7%, 8/120 cases), nut(1.7%, 2/120 cases), and others(2.5%, 3/120 cases). The type of allergic reaction: 107 cases (90.8%) of hypersensitivity reaction occurred, with 24 cases (21.7%) of severe hypersensitivity reaction, and 13 cases (9.2%) of delayed hypersensitivity reaction.The involved systems include skin and mucous membrane, respiratory system, cardiovascular system, digestive system and nervous system.The correlation coefficient between serum specific IgE and severe allergic reaction was 0.315.Conclusions:Children with indications of OFC in the admission hospital have a high risk of OFC allergic reaction.Nearly 90% of them are immediate hypersensiti-vities, even anaphylaxis.Anaphylaxis that is caused by OFC and may lead to life risk or even death should be avoided.
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Since the safety re-evaluation of traditional Chinese medicine(TCM) injections began in 2009, some TCM injection companies and research institutes have done a lot of work. And with the increase of drug development and drug production technology levels in China, the safety of some TCM injections has been greatly improved. There are safety risks in TCM injections, which are mainly reflected in unclear basis of medicinal materials, simple production process, poor controllability of quality standards, nonstan-dard drug instructions and irrational medication in the use process. This paper describes the research progress of the above-mentioned aspects of TCM injections. In addition, the author team found that adverse reactions of TCM injections are mainly pseudo-allergic reactions. Therefore, a lot of work has been done in detection of pseudo-allergic reactions, mechanism research and risk control. This part of the work is also described in this article.
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Humanos , China , Medicamentos de Ervas Chinesas/efeitos adversos , Hipersensibilidade/etiologia , Injeções , Medicina Tradicional Chinesa/efeitos adversosRESUMO
【Objective】 To explore the incidence of adverse reactions to blood transfusion in Wuxi, so as to provide theoretical basis for further improving the safety of blood transfusion in this area. 【Methods】 211 778 cases of blood transfusion in hospitals in Wuxi from 2017 to 2019 were collected, and the incidence of adverse reactions were retrospectively analyzed. 【Results】 From 2017 to 2019, 750 cases of adverse reactions occurred in Wuxi, with the incidence rate at 0.35%(750/211 778), which kept increasing year by year. The incidence of reactions relative to apheresis platelet transfusion was the highest, about 0.86% (accounting for 32.8%, 246/750), viral inactivated frozen plasma transfusion 0.1% (accounting for 30.4%, 228/750), showing an increasing trend year by year, suspension of leukocytes reduced RBC 0.12%(257/220 106), washed RBC 0.08%(5/6 439) and cryoprecipitate 0.02%(14/750) respectively (the above three accounting for 36.8%, 216/750). The adverse reactions were mainly allergic reactions (67.6%, 507/750) and febrile non-haemolytic transfusion reaction(FNHTR) (28.8%, 216/750), and the incidence of both increased year by year. In addition, there were 6 cases (0.8%, 6/750) of transfusion-associated circulation overload, 2 cases (0.27%, 2/750) of post transfusion purpura, 1 case (0.13%, 1/750) of transfusion-related acute lung injury and 18 miscellaneous cases (2.4%, 18/750). Further analysis revealed that red blood cell products were the main causes for FNHTR, and platelets and plasma products for allergic reactions. 【Conclusion】 The incidence of adverse reactions in Wuxi, mainly composed of allergic and febrile reactions caused by transfusions of blood components other than cryoprecipitate, was lower than the general level in China, but it kept increasing year by year. Measures should be taken by hospitals to strengthen the monitoring, reporting of adverse reactions, so as to prevent and further reduce the incidence of adverse reactions.
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@#Introduction: Acute transfusion reactions (ATR) are commonly reported in clinical transfusion practice, which may result in significant morbidity and mortality. This study aims to explore the impact of transfusion practice on the prevalence, characteristics, and associated factors of ATR at Hospital Sultanah Bahiyah, Kedah, Malaysia. Methods: This was a retrospective study using records from haemovigilance forms of reported transfusion reactions, E-Delphyn (blood bank system), and E-His (hospital information system). A total of 118 cases of ATR from January 1, 2015 until December 31, 2017 were selected and analysed. For each case, a control was selected from a patient who did not develop ATR. Results: A total of 122,215 units of whole blood and blood component transfusions have been performed and 415 ATR were reported. The prevalence of ATR was 0.34% or one in 294 units transfused. There was a significant association between ATR and red cell concentrate (RCC) stored for more than 14 days (adj OR = 65.29, 95% CI 9.29-458.85). The most common ATR were allergic reactions with 63 cases (53.4%), followed by febrile non-haemolytic transfusion reactions (FNHTR) with 45 cases (38.1%). Allergic reactions were significantly associated with female patients (p = 0.038) and the paediatrics age group (p = 0.038). Multivariate analysis revealed a significant association between FNHTR and RCC stored more than 14 days (p = 0.002). Conclusion: The prevalence of ATR in this hospital was low and associated with RCC stored for more than 14 days. Implementation of pre-storage leucoreduction is recommended.
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Background:Allergic transfusion reactions (ALTR) are very common complication of blood transfusion. Advances in transfusion medicine have significantly decreased the incidence of ALTR; however, ALTR continue to be burdensome for transfusion dependent patients. It increases their existing sufferings. Allergic reaction is more common in platelet concentrate transfusion because stored platelet concentrate supernatants (PCSNs) accumulate striking levels of biological response modifiers (BRMs) during storage. Objective: To determine the risk factors of allergic reactions in platelate concentrate transfusion. Method: It is a case control study enrolled a total of 64 diagnosed case of aplastic anaemia receiving transfusion of platelet concentrate at Department of Transfusion Medicine, BSMMU, Dhaka, from May 2015 to April 2016. Among them 32 case of aplastic anaemia having allergic reaction due to transfusion of platelet concentrate was considered as group I (case) and rest 32 patients not developed allergic transfusion reaction due to transfusion of platelet concentrate was considered as group II (control). Patients age belong to 5 - 50 years and both sex and also patients getting transfusion of plate late concentrate were enrolled in this study. Statistical analysis: Statistical analyses were carried out by using the Statistical Package for Social Sciences version 20.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Chi-Square test, Odds ratio with 95% CI used to analyze the categorical variables, shown with cross tabulation. Student ttest used for continuous variables. Significant value of 'p' was decided to be at a level of 0.05 in two tailed tests. Result: The mean age was found 22.1±11.58 years in group I and 23.5±3.8 years in group II. Twenty four (75.0%) patients were male in group I and 17(53.1%) patients in group II. Almost twenty (62.5%) patients come from urban area in group I and 19(59.4%) in group II. In group I, thirty two (100.0%) patients had urticarialrash, 100.0% had itching, 37.5% had angioedema, 3.1% had cough, 3.1% had chest pain, 3.1% had respiratory distress, 3.1% had fever and 3.1% had vomiting. Almost twenty(62.5%) patients had tachycardia (>100 bpm) in group I and all patients had normal pulse in group II.Thirty two (100.0%) patients had normal blood pressure in both group. In group I, 31(96.9%) patients developed mild allergic reaction, 3.1% moderate allergic reaction. Majority (40.6%) patients belonged to age 16-30 years in present allergic transfusion reaction and 11(34.3%) in absent allergic transfusion reaction. Most (40.6%) of the patients was found blood group B in present allergic transfusion reaction and 11(34.4%) in absent allergic transfusion reaction. Multiple unit of PC transfusion increases 3.69 times risk to develop allergic transfusion reactions with 95% CI 0.99 to 14.44%.Platelet concentrate storage>3daysincreases 5.95timesrisktodevelopallergic transfusionreactionwith95%CI1.75to21.09%. Conclusion: Multiple unit (≥2) transfusion and Platelet concentrate storage >3 days were significantly (p<0.05) associated with allergic transfusion reactions but no significant association was found between allergic transfusion reactions with age and Blood group.
RESUMO
La L-asparaginasa es un medicamento utilizado en distintas fases de todos los protocolos de tratamiento actuales de la leucemia linfoide aguda (LLA). Se describen múltiples manifestaciones secundarias a la L asparaginasa entre las que las reacciones alérgicas son las más frecuente. Se estudiaron 144 niños con diagnóstico de LLA tratados en el Instituto de Hematología e Inmunología, entre 1998 y el 2013. En 30 pacientes (21 por ciento) se presentaron reacciones alérgicas, similar a lo descrito en la literatura. El 76,6 por ciento de ellos habían recibido una dosis acumulativa menor de 80 000 UI (media de 48 757) y el mayor número de las reacciones alérgicas (86,7 por ciento) se reportó entre las dosis 9 y 18 recibidas (media de 11 dosis). Se observó una mayor supervivencia en los enfermos que recibieron más dosis (19 - 26 dosis) (p = 0.003). La sobrevida libre de eventos fue también mayor en este grupo (p= 0.357)(AU)
ABSTRACT L-asparaginase is a medication used in different phases of all current treatment protocols for acute lymphoid leukemia. Multiple secondary manifestations to L- asparaginase are described, and allergic reactions are the most frequent. We studied 144 children with acute lymphoblastic leukemia treated at the Instituto de Hematología e Inmunología between 1998 and 2013. Thirty patients (21 percent) had allergic reactions, similar to what is described in literature; 76.6 percent of them had received a cumulative dose of less than 80 000 IU (average of 48 757); and the highest number of allergic reactions (86.7 percent) was reported between doses 9 and 18 received (mean of 11 doses). A greater global survival was observed in patients who received more doses (19 - 26 doses) (p=0.003). Event free survival was also higher in this group (p= 0.357)(AU)