Edit concept Question Editor Create issue ticket

Febrile Transfusion Reaction


Presentation

  • Circulating immune complex, HLA, and platelet antibodies were not present. The granulocyte antibodies fluctuated in titers with disease activities, and could be completely removed from the serum by autologous granulocyte absorption.[ncbi.nlm.nih.gov]
  • Patients present with an unexpected temperature rise ( 38ºC or 1ºC above baseline, if baseline 37ºC) during or shortly after transfusion. This is usually an isolated finding. Occasionally the fever is accompanied by chills.[transfusion.com.au]
  • […] the blood component, or another type of transfusion reaction e.g. acute hemolytic transfusion reaction. [4] Fever must be at least 38 o C/100.4 o F oral and a change of at least 1 o C/1.8 o F from pre-transfusion value OR chills and/or rigors must be present[en.wikipedia.org]
  • These antigens are present on donor lymphocytes, granulocytes, or platelets. Investigation Clinically assess the transfused patient for fever, chills, rigors and headache. Acute haemolytic reaction may need exclusion.[blood.gov.au]
  • Presents as respiratory distress and noncardiogenic pulmonary edema.[errolozdalga.com]
Fever
  • (inanition) (of unknown origin) (persistent) (with chills) (with rigor) R50.9 ICD-10-CM Diagnosis Code R50.9 Fever, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Fever NOS Fever of unknown origin [FUO] Fever with chills Fever with[icd10data.com]
  • Familial Mediterranean fever (Medical Encyclopedia) Fever (Medical Encyclopedia) When your baby or infant has a fever (Medical Encyclopedia) [ Read More ][icdlist.com]
  • (mostly associated with pRBCs) Clinical features Fever; may be accompanied by chills, rigors, cold and discomfort No complications but costs time and money to rule out more serious transfusion reactions Diagnosis Must exclude all causes for fever, such[pathologyoutlines.com]
  • (see Fever, [[Fever]]) Treatment Stop the Transfusion : usually resolves without sequelae Rule Out a Acute Hemolytic Transfusion Reaction (see Acute Hemolytic Transfusion Reaction, [[Acute Hemolytic Transfusion Reaction]]) Anti-Pyretics : aspirin should[mdnxs.com]
  • Fever may persist for 8 to 12 hours. Chills may precede the fever or occur up to 30 minutes after the onset of fever. In some patients, headache, flushing, or tachycardia may accompany fever and chills.[clinlabnavigator.com]
Fever
  • (inanition) (of unknown origin) (persistent) (with chills) (with rigor) R50.9 ICD-10-CM Diagnosis Code R50.9 Fever, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Fever NOS Fever of unknown origin [FUO] Fever with chills Fever with[icd10data.com]
  • Familial Mediterranean fever (Medical Encyclopedia) Fever (Medical Encyclopedia) When your baby or infant has a fever (Medical Encyclopedia) [ Read More ][icdlist.com]
  • (mostly associated with pRBCs) Clinical features Fever; may be accompanied by chills, rigors, cold and discomfort No complications but costs time and money to rule out more serious transfusion reactions Diagnosis Must exclude all causes for fever, such[pathologyoutlines.com]
  • (see Fever, [[Fever]]) Treatment Stop the Transfusion : usually resolves without sequelae Rule Out a Acute Hemolytic Transfusion Reaction (see Acute Hemolytic Transfusion Reaction, [[Acute Hemolytic Transfusion Reaction]]) Anti-Pyretics : aspirin should[mdnxs.com]
  • Fever may persist for 8 to 12 hours. Chills may precede the fever or occur up to 30 minutes after the onset of fever. In some patients, headache, flushing, or tachycardia may accompany fever and chills.[clinlabnavigator.com]
Chills
  • Chills may precede the fever or occur up to 30 minutes after the onset of fever. In some patients, headache, flushing, or tachycardia may accompany fever and chills.[clinlabnavigator.com]
  • […] bacterial contamination of the blood component, or another type of transfusion reaction e.g. acute hemolytic transfusion reaction. [4] Fever must be at least 38 o C/100.4 o F oral and a change of at least 1 o C/1.8 o F from pre-transfusion value OR chills[en.wikipedia.org]
  • Because fever and chills also herald a severe hemolytic transfusion reaction, all febrile reactions must be investigated as with any transfusion reaction.[openanesthesia.org]
  • Occasionally the fever is accompanied by chills.[transfusion.com.au]
  • Transfusion Reaction (see Acute Hemolytic Transfusion Reaction, [[Acute Hemolytic Transfusion Reaction]]) Anti-Pyretics : aspirin should be avoided in the setting of thrombocytopenia Meperidine (Demerol) (see Meperidine, [[Meperidine]]): for severe chills[mdnxs.com]
Rigor
  • […] between 1 and 2 o C from pre-transfusion values but no other symptoms or signs [6] Moderate [ edit ] Fever of at least 39 o C, OR a rise in temperature of at least 2 o C from pre-transfusion values AND/OR other symptoms or signs, including chills ( rigors[en.wikipedia.org]
  • These antigens are present on donor lymphocytes, granulocytes, or platelets.(1,2) Investigation Clinically assess the transfused patient for fever, chills, rigors and headache. Acute haemolytic reaction may need exclusion.[transfusion.com.au]
  • […] temperature contaminating leukocytes remain functional); or (b) recipient WBC antibodies against leukocytes transfused antigen - antibody complex release of endotoxin fever (mostly associated with pRBCs) Clinical features Fever; may be accompanied by chills, rigors[pathologyoutlines.com]
  • Meperidine (Demerol) may be helpful in treating rigors. Only 1 in 7 patients experiencing a febrile nonhemolytic reaction will have another reaction at their next transfusion.[clinlabnavigator.com]
  • The ISBT suggests that for the purpose of international comparisons, only the most severe cases of FNHTR should be reported (fever 39 C oral or equivalent and a change of 2 C from pre‑transfusion value; chills/rigors).[blood.gov.au]
Rigor
  • […] between 1 and 2 o C from pre-transfusion values but no other symptoms or signs [6] Moderate [ edit ] Fever of at least 39 o C, OR a rise in temperature of at least 2 o C from pre-transfusion values AND/OR other symptoms or signs, including chills ( rigors[en.wikipedia.org]
  • These antigens are present on donor lymphocytes, granulocytes, or platelets.(1,2) Investigation Clinically assess the transfused patient for fever, chills, rigors and headache. Acute haemolytic reaction may need exclusion.[transfusion.com.au]
  • […] temperature contaminating leukocytes remain functional); or (b) recipient WBC antibodies against leukocytes transfused antigen - antibody complex release of endotoxin fever (mostly associated with pRBCs) Clinical features Fever; may be accompanied by chills, rigors[pathologyoutlines.com]
  • Meperidine (Demerol) may be helpful in treating rigors. Only 1 in 7 patients experiencing a febrile nonhemolytic reaction will have another reaction at their next transfusion.[clinlabnavigator.com]
  • The ISBT suggests that for the purpose of international comparisons, only the most severe cases of FNHTR should be reported (fever 39 C oral or equivalent and a change of 2 C from pre‑transfusion value; chills/rigors).[blood.gov.au]
Tachycardia
  • In some patients, headache, flushing, or tachycardia may accompany fever and chills. Patients, who are febrile at the onset of transfusion or have been febrile in the preceding 24 hours, are more prone to febrile reactions.[clinlabnavigator.com]
  • Fever, chills, sweats Warm or clammy skin Vomiting Rash Tachycardia, tachypnea Hypothermia Delayed haemolytic transfusion reaction Allo-immunization to other antigens.[learn.pediatrics.ubc.ca]
  • Hemolytic reactions: hypotension, tachycardia, hemoglobinuria and microvascular bleeding due to administration of ABO-incompatible blood transfusions can be life-threatening.[enotes.tripod.com]
  • The patient will present with respiratory distress, tachycardia, hypertension, acute or worsening pulmonary oedema and a positive fluid balance (Australian Red Cross Blood Service 2017; Crisp & Taylor 2012).[ausmed.com]
  • The clinical characteristics of platelet transfusion reactions vary from febrile NHTR and allergic reactions to chills, discomfort, tachycardia, and respiratory difficulties.[www3.mdanderson.org]
Myalgia
  • […] pre-transfusion values but no other symptoms or signs [6] Moderate [ edit ] Fever of at least 39 o C, OR a rise in temperature of at least 2 o C from pre-transfusion values AND/OR other symptoms or signs, including chills ( rigors ), painful muscles ( myalgia[en.wikipedia.org]
  • Myalgia. Nausea. Pain in the abdomen, flank or chest. Shortness of breath. Signs Fever (rise of 1.5 C or more) and rigors. Hypotension or hypertension. Tachycardia. Respiratory distress. Oozing from wounds or puncture sites. Haemoglobinaemia.[patient.info]
Anuria
  • Thirty-two hours later the patient developed fever (40 C) and hypotension followed by disseminated intravascular coagulation, metabolic acidosis and anuria. Direct and indirect antiglobulin tests were negative on a post-transfusion sample.[bloodjournal.org]
  • Fahrenheit Chills with or without rigors Chest, flank, abdominal, or back pain Hives, rash, flushing, pruritus Respiratory distress, including wheezing, coughing New or increased oxygen requirement Nausea and/or vomiting Pain at infusion site Oliguria or anuria[clinicaladvisor.com]
Seizure
  • Other causes of fevers include Medicines, including some antibiotics, blood pressure medicines, and anti-seizure medicines Heat illness Cancers Autoimmune diseases Some childhood immunizations Treatment depends on the cause of your fever.[icdlist.com]
  • However, concerns remain that intravenously delivered TXA (ivTXA) may increase risks of postoperative convulsive seizures and systemic thrombogenicity.[read.qxmd.com]
Febrile Convulsions
  • convulsions ( R56.0- ) fever of unknown origin during labor ( O75.2 ) fever of unknown origin in newborn ( P81.9 ) hypothermia due to illness ( R68.0 ) malignant hyperthermia due to anesthesia ( T88.3 ) puerperal pyrexia NOS ( O86.4 ) Fever of other[icd10data.com]
Quadriplegia
  • […] elsewhere R50.82 Postprocedural fever R50.83 Postvaccination fever R50.84 Febrile nonhemolytic transfusion reaction R50.9 Fever, unspecified R52 Pain, unspecified R53 Malaise and fatigue R53.0 Neoplastic (malignant) related fatigue R53.2 Functional quadriplegia[icd10data.com]
Myelopathy
  • Human T-cell lymphotropic virus 1 (HTLV-1), which can cause adult T-cell lymphoma/leukemia and HTLV-1–associated myelopathy/tropical spastic paraparesis, causes posttransfusion seroconversion in some recipients.[merckmanuals.com]

Workup

  • I don't feel that we are doing a large number of workups simply because the patient transfusion started with an elevated temp.[pathlabtalk.com]
  • Provide supportive care to patient while initiating a TR workup.[clinicaladvisor.com]
  • A combined testing approach is generally needed; several reference laboratories (including Mayo Medical Laboratories and BloodCenter of Wisconsin) offer PTP workup panels aimed at maximizing sensitivity.[academic.oup.com]
Erythroblast
  • WBC 13.1 10 9 /L platelet count 953 10 9 /L erythroblasts 12.7% of nucleated cells.[bloodjournal.org]

Treatment

  • […] and management Stop the transfusion Notify the transfusion medicine service Rule out other causes, such as hemolysis (DAT, visual check for hemoglobinemia), bacterial contamination (culture the product if necessary) Symptomatic treatment: acetaminophen[pathologyoutlines.com]
  • , admission to hospital, or lengthens the duration of hospital admission [6] Treatment [ edit ] Paracetamol has been used in treatment, and leukoreduction of future transfusions is sometimes performed. [7] References [ edit ] External links [ edit ][en.wikipedia.org]
  • Now, in its Sixth Edition, Cancer Nursing reflects the constantly shifting progress in the science of oncology, as well as emerging new therapies, new treatment modalities, the latest results from clinical trials, updates on new chemotherapeutic agents[books.google.com]
  • Alternatively, FNHTR can be mediated by pre-formed cytokines in the donor plasma as a consequence of white blood cell breakdown. [1] [2] It is abbreviated "FNHTR". [3] Acetaminophen has been used in treatment, and leukoreduction of future transfusions[ipfs.io]
  • Manifestations Mild Dyspnea (see Dyspnea, [[Dyspnea]]) Transfusion-Associated Acute Lung Injury (TRALI) (see Transfusion-Associated Acute Lung Injury, [[Transfusion-Associated Acute Lung Injury]]) Other Manifestations Chills Fever (see Fever, [[Fever]]) Treatment[mdnxs.com]

Prognosis

  • After the acute phase, the degree of acute kidney injury determines the prognosis. Diuresis and a decreasing BUN usually portend recovery. Permanent renal insufficiency is unusual. Prolonged oliguria and shock are poor prognostic signs.[merckmanuals.com]

Etiology

  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]
  • The exact etiology is unclear. However, the most accepted hypothesis is that a patient who is negative for human platelet antigen 1a (HPA1a) develops alloantibodies due to exposure to HPA1a antigen from the fetus during pregnancy.[merckmanuals.com]
  • Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors. Blood. 2003 Jan 15. 101(2):454-62. [Medline]. [Full Text]. Blajchman MA.[emedicine.medscape.com]
  • Familiarity with the incidence, etiology, management, and prevention of commonly encountered transfusion reactions is integral to the practice of transfusion medicine.[academic.oup.com]

Epidemiology

  • Epidemiology Incidence : most common type of transfusion reaction Physiology Mechanism : believed to be associated with class I HLA antibodies (or sometimes granulocyte specific antibodies) directed against the contaminating leukocytes in the transfused[mdnxs.com]
  • Transfusion-related acute lung injury: epidemiology and a prospective analysis of etiologic factors. Blood. 2003 Jan 15. 101(2):454-62. [Medline]. [Full Text]. Blajchman MA.[emedicine.medscape.com]
  • Epidemiology See Table II. Incidence of transfusion reactions Table II.[clinicaladvisor.com]
  • Transfusion. 2011 ; 51 : 2549 – 2554. 6 et al. for the National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study–II (REDS-II).[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • Definition / general Increase of 1 degree Centigrade associated with transfusion, without hemolysis, that cannot be attributed to other causes (diagnosis of exclusion) Usually occurs within 2 hours of transfusion Pathophysiology Associated with leukocytes[pathologyoutlines.com]
  • Medicine CAM Therapies 590 Role of EindenceBased Practice 596 Cancer Symptom Management 621 26 639 Change in PerceptionSensation of Pain 668 Infection 689 Bleeding 715 Normal Nutritional Physiology 764 lypercalcemia 771 Paraneoplastic Syndromes 805 Pathophysiology[books.google.com]
  • Acute hemolytic transfusion reaction, a paradigm of the systemic inflammatory response: new insights into pathophysiology and treatment. Transfusion. 1995 Jun. 35(6):513-20. [Medline]. Davenport RD.[emedicine.medscape.com]
  • Blood transfusion reactions can be classified based on the timing of onset (acute vs. delayed) and the pathophysiological mechanism (immune vs. non-immune related).[learn.pediatrics.ubc.ca]
  • (Reviews the pathophysiology of transfusion reactions.) Alter, HJ, Klein, HG. Blood. vol. 112. 2008. pp. 2617-26. (Reviews both infectious and non-infectious complications of blood transfusion with an historical perspective.)[clinicaladvisor.com]

Prevention

  • Transfusion. 2008;48(11):2285 [ MEDLINE ] Leukoreduction for the prevention of adverse reactions from allogeneic blood transfusion. Cochrane Database Syst Rev. 2015 Dec 3;12:CD009745. doi: 10.1002/14651858.CD009745.pub2 [ MEDLINE ][mdnxs.com]
  • We conclude that LP RBCs are adequate to prevent recurrence of FNHTR and question the need for costly saline-washed, leukocyte-poor red blood cells for this purpose.[ncbi.nlm.nih.gov]
  • 目次 40 925 The Care of Individuals with Cancer 959 44 979 Prognostic Indicators 985 45 1004 Nursing Care 1019 Central Nervous System Cancers 1068 Susan Vogt Temple RN MSN AOCN 48 1137 Janice PostWhite RN PhD FAAN 2 Chicago IL 70 Dynamics of Cancer Prevention[books.google.com]
  • We conclude that pre-transfusion testing of group 0 donors and recipients for isohemolysins combined with platelet crossmatching may prevent febrile reactions. 1988 S. Karger AG, Basel Article / Publication Details First-Page Preview[karger.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!