QuestionSBA
QuestionChoice
Acute haemolytic reactions occur within 24 hours of transfusion due to ABO incompatibility and normally present with a triad of symptoms: fever, flank pain, and red or brown urine. Further investigations would show a raised bilirubin and LDH, and an acute fall in haemoglobin.
10003965
e
Acute haemolytic reaction
QuestionChoice
Whilst renal biopsies can be carried out to investigate the cause of nephrotic syndrome, the patient's pattern of symptoms is not in keeping with nephrotic syndrome. Nephrotic syndrome is associated with hypoalbuminaemia (and fluid overload) and massive proteinuria.
10003963
c
Nephrotic syndrome
QuestionChoice
This pattern of symptoms following blood transfusion are more in keeping with a diagnosis of transfusion-associated acute lung injury.
10003962
b
Heart failure
QuestionChoice
TRALI causes acute pulmonary oedema within 6 hours of transfusion. It is caused by antibodies in the donor blood reacting with the patient’s white blood cells (neutrophils and monocytes) or pulmonary endothelium, causing inflammatory cells to be sequestered in the lungs. This results in the leakage of plasma into the alveolar spaces and acute respiratory distress.
10003961
a
Transfusion-associated acute lung injury (TRALI)
QuestionChoice
TACO can also present within 6 hours of transfusion, but it is associated with hypertension, not hypotension, and is generally in older patients. It also does not present with a high temperature.
10003964
d
Transfusion-associated circulatory overload (TACO)
Concept
Chapter
2693
4190
Complications of blood transfusions
Topic
157
Haematology
13339
A 32-year-old man receives a blood transfusion after experiencing bleeding following a renal biopsy. 4 hours later he develops rapid onset dyspnoea and tachypnoea. His blood pressure is 95/65 and his temperature is 37.8°C.

An ABG is carried out and shows a normal LDH.

Which of the following is the most likely cause of his symptoms?
a