A known IgA-deficient patient develops urticaria, wheeze, and hypotension within minutes of starting a packed red cell transfusion. For future transfusions in this patient, the appropriate product modification is:

• A Leucodepleted red cells
• B CMV-seronegative red cells
• C Irradiated red cells
• D Washed red cells ✓

Explanation

Anaphylactic reactions in IgA-deficient recipients are caused by anti-IgA antibodies reacting with trace IgA in donor plasma. Washing removes residual plasma protein including IgA, so washed red cells are the correct choice. Leucodepletion addresses febrile non-haemolytic reactions and CMV risk, irradiation prevents graft-versus-host disease in immunocompromised recipients, and neither removes plasma IgA.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.