Pediatric Acute Transfusion Reactions: Diagnostic Pitfalls and Emerging Mechanisms


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ÖZDEMİRAL C., Aytekin E. S., KUŞKONMAZ B. B., OKUR F. V., ÇAĞDAŞ AYVAZ D. N., ŞEKEREL B. E.

Asthma Allergy Immunology, cilt.24, sa.1, ss.26-32, 2026 (ESCI, Scopus, TRDizin) identifier

  • 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.