Pediatric Acute Transfusion Reactions: Diagnostic Pitfalls and Emerging Mechanisms
Asthma Allergy Immunology, cilt.24, sa.1, ss.26-32, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 24 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.21911/aai.2026.1169
- Dergi Adı: Asthma Allergy Immunology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.26-32
- Anahtar Kelimeler: Acute transfusion reaction, anaphylaxis, hematopoietic stem cell transplantation, hemolytic transfusion reaction, passive allergen transfer
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Hacettepe Üniversitesi Adresli: Evet
Özet
Acute transfusion reactions (ATRs) in children represent a heterogeneous group of allergic, immunologic, and non-immunologic events that can be life-threatening and clinically indistinguishable, particularly in immunocompromised cohorts. This case-based narrative review explores the spectrum of pediatric ATRs, focusing on pathophysiological mechanisms, diagnostic hurdles, and management strategies. The discussion is framed by two pediatric cases involving four distinct ATRs: first, a child with DOCK8 deficiency undergoing hematopoietic stem cell transplantation who experienced urticaria and subsequent anaphylaxis due to suspected passive allergen transfer; and second, a child with malignancy who developed febrile non-hemolytic and acute hemolytic reactions despite ABO compatibility. These scenarios are analyzed alongside critical entities such as transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI). This review underscores the need for heightened clinical vigilance and highlights passive allergen transfer as an increasingly recognized mechanism essential to enhancing pediatric transfusion safety.