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Pulmonary Hypersensitivity Reaction After Blood Transfusion

Howard N. Ward, MC; Thomas S. Lipscomb, MC; Leo P. Cawley, MD
Arch Intern Med. 1968;122(4):362-366. doi:10.1001/archinte.1968.00300090072017.
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Pulmonary edema following blood transfusion due to circulatory overload is a fundamental and generally appreciated phenomenon. However, pulmonary edema as a hypersensitivity type adverse transfusion reaction is rarely reported in either the extensive literature on pulmonary edema or untoward transfusion reactions. Although this unusual entity is briefly noted in certain radiologic references,1,2 only the reports of Barnard 3 and Phillips and Fleischner 4 deal with the clinical point of view. In all of these instances, the etiologic mechanism has been attributed to an immune basis similar in type to angioneurotic edema or urticaria of the systemic circulation. Well known allergic transfusion reactions include urticaria, angioneurotic edema, laryngeal edema, bronchospasm, rarely anaphylaxis, and perhaps a significant percentage of so-called nonspecific febrile reactions which may be due to sensitivity to donor leukocytes and platelets.5-9 The purpose of this paper is to call the clinician's attention to this unusual cause of


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