Acute Pain Transfusion Reaction

[simret 19]

Does any of you has experience with Acute Pain Transfusion Reaction? What causes Acute Pain Reaction?

Thank you!

[slsmith 55]

Haven't  had one in my career but it is a symptom of a hemolytic transfusion reaction

[simret 19]

Pre/Post Poly DAT = neg, no fever, Urinalysis= neg, Screen pre/post = neg. How can that be Hemolytic tx. reaction?

[slsmith 55]

I didn't see this additional information. 

[simret 19]

My apologies. I did not mention it in my details.

[JasonS 22]

In theory the "classic" situations with acute pain are an Acute Hemolytic Reaction(as mentioned above). I have also never seen one of these practice.

Have you repeated the crossmatch with the unit and a new sample? Have they done bloodwork for hemolysis markers?

The pain could always be due to one of the other common transfusion reaction causes(not everything presents in textbook fashion), or not due to transfusion at all. 

[John C. Staley 1,113]

Just a thought but why must the acute pain be associated with the transfusion?  Why was the patient being transfused, trauma, chronic anemia, etc.?  It makes a difference.  Where was the pain, at the site the blood was going in, along the same vein, some other part of the body?  I know that it is a natural reaction for us to associate anything unexpected which occurs during or shortly after a transfusion to associate it with the transfusion but that is not always the case.  It is worth the effort to also look elsewhere for the cause.  As I've mentioned in other threads, I've seen a temp rise post transfusion that was caused by the window blinds being open and the sun shining directly on the patient.  Bottom line is that it is not always the transfusion causing what you are seeing.  Keep an open mind.

[simret 19]

Good thinking. Pre and post Type and screen were negative. Actually, the patient has a Thalassemia trait who received two RBCs exchange with no reaction. The third RBC however the patient encountered 9 out of 10 pain on the pain scale. The location of the pain was at the joints, knees, and back. Given Morphine; After 1/2 hr, pain when away.  All three units were retyped, crossmatched. All checked out.

[David Saikin 1,387]

I always (and still am) under the impression that the pain would be at the infusion site if associated w a HTRX

[Baby Banker 81]

There can be back pain in an HTR, although there are LOTS of other things that can cause back pain.

[John C. Staley 1,113]

50 minutes ago, Baby Banker said:

There can be back pain in an HTR, although there are LOTS of other things that can cause back pain.

For some reason I was always under the impression that the back pain was associated with the kidneys trying to deal with all the rbc detritus resulting from an HTR.  That being the case, I can not imagine that would be the only symptom but one of many. 

[Baby Banker 81]

There can be back pain in an HTR, although there are LOTS of other things that can cause back pain.

 

HTRs generally have multiple symptoms due to the severity of the reaction., and can actually be caused by other things than immune response.