Severe Allergic Pulmonary Oedema after Plasma Transfusion

Abstract

S ummary . Three patients with haemophilia suffered severe febrile reactions after transfusions of fresh frozen plasma and developed pulmonary oedema which did not appear to be due to circulatory overload. The chest radiographs were characterized by widespread patchy rounded opacities resembling bronchopneumonia. In one of the patients the reaction proved fatal; in the other two, treatment was followed by the rapid resolution of symptoms, clinical signs and the abnormal chest radiograph. In two of the patients there was evidence that the reactions might have been caused by transfer of antibodies to white cell or Gm factors from the donor to the recipient. It is recommended that haemophiliacs with a history of transfusion reactions should only be treated with concentrated preparations of factor VIII and not with fresh frozen plasma.