Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 23-year-old woman with no relevant medical history required transfusion of 2 units of fresh frozen plasma before diagnostic laparoscopy. Following transfusion, serious bilateral pulmonary edema with hypoxia developed and resolved with 48 hours of mechanical ventilation. Immunological testing of blood from the 2 donors and the patient revealed the presence of anti-HLA DR-52 antibodies in the plasma of a donor and the presence of the corresponding antigen in the patient, confirming the diagnosis of fresh frozen plasma transfusion-related acute lung injury. Transfusion-related acute lung injury associated with plasma-containing blood products has an incidence of 1:5000 transfused units and a mortality rate of up to 10% of cases. Clinical suspicion should remain high in making the diagnosis and ruling out other causes of pulmonary edema, given that a firm diagnosis will come only after immunological testing. Transfusion-related acute lung injury is considered an under-diagnosed syndrome and must be included in the differential diagnosis of respiratory distress when a transfusion has been given.
 ...
PMID:[Acute lung injury related to transfusion of fresh frozen plasma]. 1530 36

Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-associated mortality. TRALI occurs in children and adults, but the syndrome has not been reviewed from a pediatric perspective. We reviewed the literature on TRALI from a pediatric perspective. TRALI has been documented in pediatric patients, especially in the setting of hematologic malignancy. Additional TRALI cases have been reported in pediatric patients with a variety of diagnoses. TRALI is likely to be much more common than previously appreciated in the pediatric patient population. TRALI should be considered in the differential diagnosis of all pediatric patients who develop new acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) during or within six hours of a blood product transfusion. When a case of TRALI is suspected, a transfusion reaction report to the blood bank is important to initiate the investigation and identify the implicated donor.
 ...
PMID:Transfusion related acute lung injury: a pediatric perspective. 1651 13

Transfusion-related acute lung injury (TRALI) occasionally causes serious symptoms that may be fatal to recipients. Polymorphonuclear neutrophils (PMNs) and alloantibodies specific to PMN cell surface antigens are suspected to cause TRALI. The aim of this study is to establish a sensitive and stable procedure of detecting alloantibodies not only in donor blood, but also in recipient's plasma. We have introduced a new method of detecting alloantibodies based on double-determinant enzyme-linked immunosorbent assay (DD-ELISA) and a monoclonal antibody-immobilized granulocyte antigen (MAIGA) test (arbitrarily designated as modified DD-ELISA). We verified the specificity of alloantibodies against PMN cell surface antigens in plasma samples from three normal healthy donors of blood that induced respiratory distress in recipients after a blood transfusion. Anti-CD32 (Fc gamma RIII) alloantibodies were detected in all the plasma samples using two different clones of the monoclonal anti-CD32 antibody. The specificities of these plasma samples could not be identified by the granulocyte immunofluorescence test (GIFT) using typed test cells. Except for the anti-CD32 alloantibodies, one plasma sample was proved to have the anti-HNA-1a alloantibodies. In another plasma sample, the anti-HNA-2a alloantibodies were detected. By modified DD-ELISA, we could clearly specify the presence of alloantibodies in the three plasma samples. Our results also suggest that the anti-CD32 alloantibodies can be generated in vivo and may play some roles in the development of TRALI.
 ...
PMID:Detection of anti-CD32 alloantibody in donor plasma implicated in development of transfusion-related acute lung injury. 1628 15

Transfusion-Related Acute Lung Injury or TRALI is one of the most frequent severe transfusion reactions ( one third of Non Hemolytic Febrile Transfusion Reactions). It presents as a generally mild form of acute respiratory distress syndrome occurring 1 to 2 hours after transfusion of a plasma-containing blood component. This transfusion reaction appears, most of the time, in patients with focal inflammation and is of good prognosis when adequately diagnosed and treated. TRALI prevention rests on donor selection for plasma donation, hemovigilance system effectiveness and restrictive transfusion strategy.
 ...
PMID:[Transfusion-related acute lung injury (TRALI): emerging or main transfusion hazard?]. 1645 31

The paper by Fung YL and Williams BA describes TRALI in leukemic children in order to raise awareness of the need to include this in the differential diagnosis of acute respiratory distress. Detection of TRALI in children with other co-morbidities is difficult. Well-documented cases of TRALI in children are few due to the lack of recognition and difficulty in identifying the antibodies since these may not be always present. Hematology/oncology patients who are chronically transfused and are allo-immunized are at greater risk than the general pediatric population. Thus an awareness of this reaction to blood transfusion helps facilitate prompt treatment and preventive measures.
 ...
PMID:Commentary on TRALI in leukemia. 1679 10

Transfusion-related acute lung injury and transfusion-associated circulatory overload are important, life-threatening complications of transfusion. Each adversely impact hospital length of stay and cost of healthcare. TRALI is clinically indistinguishable from the adult respiratory distress syndrome but it has a more favorable prognosis. Approximately 10% of TRALI patients die from this complication. The at-risk patient for TRALI has not been identified. The most commonly cited incidence is 1:5000 plasma-containing blood component transfusions. Although several pathways may lead to TRALI, passive transfusion of leukocyte antibodies is currently the most important association. TACO occurs in 1-8% of patients undergoing hip or knee arthroplasty. It is precipitated by positive fluid balance and high transfusion flow rates. TACO is characterized by respiratory distress and acute pulmonary edema.
 ...
PMID:Pulmonary consequences of transfusion: TRALI and TACO. 1687 2

Transfusion-related acute lung injury (TRALI) is a rare transfusion reaction presenting as respiratory distress during or after transfusion of blood products. TRALI varies in severity, and mortality is not uncommon. TRALI reactions have equal gender distributions and can occur in all age groups. All blood products, except albumin, have been implicated in TRALI reactions. TRALI presents as acute respiratory compromise occurring in temporal proximity to a transfusion of a blood product. Other causes of acute lung injury should be excluded in order to definitively diagnose TRALI. Clinically and pathologically, TRALI mimics acute respiratory distress syndrome (ARDS), with neutrophil-derived inflammatory chemokines and cytokines believed to be involved in the pathogenesis of both entities. Anti-HLA and anti-neutrophil antibodies have been implicated in some cases of TRALI. Treatment for TRALI is supportive; prevention is important. It is suspected that TRALI is both underdiagnosed and underreported. One of the difficulties in the evaluation of potential TRALI reactions is, until recently, the lack of diagnostic criteria. A group of transfusion medicine experts, the American-European Consensus Conference (AECC), recently met and developed diagnostic criteria of TRALI, as well as recommendations for management of donors to prevent future TRALI reactions. In light of the AECC consensus recommendations, we report an incident of TRALI in an oncology patient as an example of the potential severity of the lung disease and the clinical and laboratory evaluation of the patient. We also review the literature on this important complication of blood transfusion that internists may encounter.
 ...
PMID:Transfusion-related acute lung injury (TRALI): current clinical and pathophysiologic considerations. 1690 43

Transfusion-related acute lung injury (TRALI) has not been systematically described in patients with burn injury, and the characterization of TRALI in patients with pre-existing acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) also is lacking. Our aim was to identify TRALI in burn patients and to attempt to characterize transfusion (TXN)-related pulmonary deterioration in burn patients with pre-existing ALI or ARDS. We undertook a retrospective review of mechanically ventilated and transfused burn patients at an adult regional burn center between January 1, 2003, and January 5, 2005. A blinded intensivist independently rated pre- and post-TXN chest radiographs (CXRs). There were 25 patients (age 51 +/- 19 years, %TBSA burns 30 +/- 19, full thickness %BSA 17 +/- 19, with a 24% incidence of smoke inhalation) who received 124 TXNs. New ALI developed within 6 hours after four TXNs. In one TXN, there were no other precipitating causes (eg, infection, inhalation injury), suggesting possible TRALI (incidence 0.8%). Existing ALI or ARDS was present before 63 (51%) of the TXNs. Definite worsening of the CXR and deterioration in the PaO2/FiO2 ratio (18% +/- 4%) within 6 hours of TXN occurred after six transfusions. In two of the TXNs, there were no other precipitating causes, suggesting possible TXN-related pulmonary deterioration (incidence 3.2%). Vigilance must be maintained for TRALI in burn patients. For patients with existing ALI or ARDS, we suggest that worsening of the CXR and reduction in the PaO2/FiO2 ratio by 20% or more within 6 hours of transfusion should be investigated for possible TRALI with appropriate donor investigations.
 ...
PMID:Transfusion-related acute lung injury in patients with burns. 1721 Dec 1

TRALI is a rare but serious complication associated with transfusion, and known to occur following infusion of all types of plasma-containing blood products. However, only one adult case of TRALI after allogenic marrow graft has been reported. In this study, we present a pediatric case possibly associated with allogenic marrow infusion. A 10-yr-old girl was referred to our hospital for the treatment of acute myeloid leukemia. She underwent allogenic bone marrow transplantation from her HLA-2-loci-mismatched mother. During conditioning, she suffered from bacterial sepsis, but it had improved with antibiotics until day 0 of transplantation. Two h after starting the marrow infusion, she developed severe hypoxia. We discontinued the infusion and started steroids, which improved her respiratory condition. However, she developed respiratory failure again after resuming infusion of the graft. Despite intensive care with mechanical ventilation, the patient died of endotoxin shock five days after transplantation. Although we could not identify the antibody which might have been involved in the respiratory distress, the clear temporal relationship between marrow infusion and respiratory distress suggested that similar acute lung injury to TRALI might have occurred following allogenic marrow infusion in the present case.
 ...
PMID:A pediatric case of transfusion-related acute lung injury following bone marrow infusion. 1763 Oct 25

Transfusion-related acute lung injury (TRALI) is a life-threatening adverse event in blood transfusion and is considered the most common cause of transfusion-related fatalities in the United States and the United Kingdom. TRALI and acute respiratory distress syndrome (ARDS) share a common clinical definition except that TRALI is temporally and mechanistically related to blood transfusion. Two different mechanisms have been proposed. The first is leuko-agglutination due to infusion of leukocyte Antibodies with the blood product transfused. The second proposes a two-event model where the first event is the clinical condition of the patient, and the second the infusion of lipids that accumulate in blood products during storage. An emerging common pathway of granulocyte activation is discussed, as is the relevance of immune and non-immune TRALI from a practical point of view. Some unresolved questions in TRALI pathophysiology, including the relevance of Antibodies to HLA class-II antigens and the participation of the endothelium, are examined, as are the suggested preventive measures for both immune and non-immune TRALI. It is concluded that further clinical and experimental data are necessary before any recommendations can be made regarding non-immune TRALI. In contrast, in immune TRALI, preventive measures to avoid transfusion of blood products that contain leukocyte Antibodies should be taken now.
 ...
PMID:Pathophysiology of TRALI: current concepts. 1767 36


<< Previous 1 2 3 4 5 6 Next >>