A readily available assay for anti-immunoglobulin A: is this what we have been waiting for?

摘要

Although anaphylactic transfusion reactions due to underlying immunoglobulin A deficiency (IgAD) are rare, it is not uncommon for transfusion medicine physicians to encounter patients with transfusion reactions with respiratory distress or hypotension, where the specter of anaphylaxis is raised. In such cases, IgAD with associated anti-IgA as the underlying cause must be excluded. Another common scenario is a patient with a purported history of IgAD, requiring a judgment in a limited time window as to whether special IgA-deficientblood components are needed for transfusion. In the majority of such cases, IgAD is not present in the patient, nor has it been an etiologic factor in a previous transfusion reaction. However, in most urgent situations, there are no diagnostic tests readily available to help us exclude the presence of IgAD or anti-IgA.