What is the primary pathophysiological cause of anaphylactic reactions during transfusions?

What is the primary pathophysiological cause of anaphylactic reactions during transfusions?

• A. Antibody in patient serum is detected 3-7 days after transfusion
• B. Donor plasma has reagins that combine with allergens in patient plasma
• C. Patient is deficient in IgE and develops IgE antibodies
• D. Patient is deficient in IgA and develops IgA antibodies via sensitization

Answer: (D)

The primary pathophysiological cause of anaphylactic reactions during transfusions is related to the presence of specific antibodies in relation to deficiencies in immunoglobulins. In the context of transfusions, when a patient is deficient in IgA, they may develop IgA antibodies through sensitization after exposure to donor plasma that contains IgA. This allergic reaction can occur because the immune system identifies the IgA from the donor as foreign, leading to the production of these antibodies. When a transfusion occurs, especially in patients who are IgA deficient, the introduction of IgA from the donor can trigger a robust immune response. This is because the patient’s immune system has already been sensitized to the IgA antigen due to previous exposure, which may not have even been related to transfusion (such as through other exposures to IgA-containing substances). Upon re-exposure during a transfusion, this can lead to an anaphylactic reaction characterized by symptoms such as difficulty breathing, hypotension, and urticaria. The other options do not accurately describe the mechanism leading to anaphylaxis related to transfusions. For example, the presence of antibodies detected days afterward, the concept of donor plasma having reagins, or deficiencies in IgE do not

The primary pathophysiological cause of anaphylactic reactions during transfusions is related to the presence of specific antibodies in relation to deficiencies in immunoglobulins. In the context of transfusions, when a patient is deficient in IgA, they may develop IgA antibodies through sensitization after exposure to donor plasma that contains IgA. This allergic reaction can occur because the immune system identifies the IgA from the donor as foreign, leading to the production of these antibodies.

When a transfusion occurs, especially in patients who are IgA deficient, the introduction of IgA from the donor can trigger a robust immune response. This is because the patient’s immune system has already been sensitized to the IgA antigen due to previous exposure, which may not have even been related to transfusion (such as through other exposures to IgA-containing substances). Upon re-exposure during a transfusion, this can lead to an anaphylactic reaction characterized by symptoms such as difficulty breathing, hypotension, and urticaria.

The other options do not accurately describe the mechanism leading to anaphylaxis related to transfusions. For example, the presence of antibodies detected days afterward, the concept of donor plasma having reagins, or deficiencies in IgE do not