Two cases of brand-specific albumin sensitivity in patients receiving regular therapeutic plasma exchange |
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Authors: | Kai J Rogers Annette J Schlueter |
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Institution: | 1. Department of Blood Transfusion, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China;2. Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing, China;3. Department of Blood Transfusion, The First Medical Center, Chinese PLA General Hospital, Beijing, China;1. Department of Medical Oncology, Adiyaman Training and Research Hospital, Adiyaman, Turkey;2. Department of Hematology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey;3. Department of Bioistatistic, Dicle University, Faculty of Medicine, Diyarbakir, Turkey;1. Istanbul Medical Faculty Hospital Blood Center, Istanbul University, Istanbul, Turkey;2. Istanbul Medical Faculty, Department of Medical Biology, Istanbul University, Istanbul, Turkey;3. Istanbul Medical Faculty, Department of Hematology, Istanbul University, Turkey;4. Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, School of Medicine, Altunizade Hospital, Ac?badem University, Istanbul, Turkey;5. Istanbul Science University, Department of Medical Biology, Istanbul, Turkey |
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Abstract: | Therapeutic plasma exchange (PLEX) involves the removal of detrimental substances, commonly pathogenic antibodies or toxins, from a patient’s blood by exchanging their plasma with a replacement fluid. While a variety of replacement fluids are available, human albumin (4–5 %) is the most commonly used, as it is widely available, easily stored, and generally well tolerated. Despite its excellent safety profile, adverse reactions to albumin are well documented, ranging in severity from mild allergic symptoms to severe anaphylaxis. This report describes two cases of patients receiving frequent PLEX who developed sensitivities to human albumin. These patients differed substantially in the manifestations of their symptoms, the duration of their treatment, and their medical indication for PLEX. In both cases, symptom onset occurred shortly after completion of plasma exchange procedures and lasted for several hours. Symptoms disappeared when the patients were switched to albumin from a different manufacturer, suggesting that the reaction was specific to that formulation of albumin and not to the albumin itself. These cases highlight the possibility of manufacturer-specific acquired albumin sensitivities and provide a simple framework for the initial approach to the management of such reactions. |
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Keywords: | Albumin Acquired sensitivity Therapeutic plasma exchange Replacement fluid |
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