Febrile nonhemolytic transfusion reaction

Background

• Occurs in 20% of patients due to recipient Ab against donor leukocytes

Clinical Features

• Fever, headache, myalgias, tachycardia, dyspnea, chest pain

Differential Diagnosis

Transfusion Reaction Types

• Acute
  • Intravascular hemolytic tranfusion reaction
  • Febrile nonhemolytic tranfusion reaction
  • Allergic tranfusion reaction
  • Transfusion-associated circulatory overload (TACO)
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated graft-versus-host disease
  • Fluid overload
  • Sepsis
• Delayed
  • Extravascular hemolytic tranfusion reaction
  • Graft-vs-host disease
  • Transfusion infections

Acute allergic reaction

• Allergic reaction/urticaria
• Anaphylaxis
• Angioedema
• Anxiety attack
• Asthma exacerbation
• Carcinoid syndrome
• Cold urticaria
• Contrast induced allergic reaction
• Scombroid
• Shock
• Transfusion reaction

Evaluation

• Rule out hemolysis - see transfusion reaction

Management

• Stop tranfusion pending rule-out of hemolytic transfusion reaction
• Give antipyretic
• Restart transfusion once hemolytic transfusion reaction is ruled-out

See Also

• Transfusion reaction