A client develops hemolytic anemia. which client medication can cause this adverse effect
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Some people experience adverse reactions during or after a blood transfusion. These reactions can range from mild to severe. However, most people who receive blood transfusions experience no complications. Show
According to the American Red Cross, people do not typically experience complications after having a blood transfusion, but they can happen occasionally. The Centers for Disease Control and Prevention (CDC) state that the most common adverse reactions are allergic and febrile (fever) transfusion reactions. In this article, we discuss the potential reactions a person may experience due to a blood transfusion.
According to a 2020 article, the most common signs that indicate a person is experiencing an adverse reaction include:
However, these symptoms can resolve with little or no treatment. Signs that indicate a more severe reaction include:
Examples of acute transfusion reactions include the following: Simple allergic reactionEven when a person receives the correct blood type, allergic reactions can occur. According to a 2013 article in the British Journal of Haematology, reactions occur due to:
SymptomsSymptoms are typically mild and include:
TreatmentTreatments for a mild allergic reaction include:
Anaphylactic transfusion reactionAnaphylactic reactions occur in those with immunoglobulin A (IgA) deficiencies and have IgA antibodies in their plasma. The recipient’s anti-IgA antibodies can react with the IgA antibodies in the donor blood. SymptomsSymptoms typically include:
TreatmentIf a person is experiencing any of the above symptoms, a nurse or doctor will stop the transfusion. After this, they will address the specific symptoms, which can include:
Febrile non-hemolytic transfusion reactionAccording to the CDC, a febrile non-hemolytic transfusion reaction (FNHTR) is the most common reaction. It involves an unexplained rise in temperature during or 4 hours after the transfusion. The fever is part of the person’s white blood cells response to the new blood. SymptomsSymptoms will depend on the severity and may include:
If other symptoms are present, the person should contact their doctor. TreatmentIf FNHTR occurs during the transfusion, the healthcare professional will stop the procedure. Treatment depends on the symptoms. However, according to the CDC, most reactions are typically mild and respond quickly to treatment.
Acute hemolytic transfusion reactionAccording to the CDC, this type of reaction occurs during, immediately afterward, or within 24 hours of the transfusion. This type of reaction occurs if a person has received the wrong blood type. A 2019 article states that an acute hemolytic transfusion reaction causes the body to start destroying the donated red blood cells. SymptomsSymptoms can include:
Less common symptoms include:
TreatmentIf a person develops an acute hemolytic transfusion reaction, the doctor or nurse will stop the transfusion. Treatment depends on the severity of the reaction and may include:
Septic transfusion reactionsAccording to a 2012 article, septic transfusion reactions typically occur due to bacterial contamination of the donor blood components, most commonly from the platelet products. The bacteria in platelets that can cause a septic transfusion reaction include Staphylococcus aureus and Staphylococcus epidermidis. SymptomsSymptoms can include:
TreatmentSeptic transfer reactions require immediate attention. Management of the condition involves
Transfusion-related acute lung injury (TRALI)This blood transfusion reaction develops very quickly. It happens when antibodies in the donor blood, such as human leukocyte antibodies, react with the recipient’s leukocytes, or white blood cells. This results in pulmonary edema, or excess fluid in the lungs. According to the American Red Cross, no specific test exists to identify which blood products will cause TRALI. SymptomsSymptoms of TRALI include:
TreatmentTreatment depends on the severity of the symptoms:
According to a 2012 article, most cases typically resolve within 48–72 hours. However, TRALI can be fatal and has a mortality rate of between 5–25%. Transfusion-associate circulatory overload (TACO)TACO occurs if a person’s circulatory system is unable to process the amount of blood or the speed at which they are receiving it. Doctors call this volume overload, and people who have heart or kidney conditions may develop it. In TACO, the circulatory system becomes overwhelmed, resulting in pulmonary edema where the lungs fill up with excess fluid. SymptomsSymptoms of TACO usually occur within a few hours of or during the transfusion and include:
TreatmentIf symptoms occur during the transfusion, the doctor or healthcare professional will stop the procedure immediately. According to LabMedicine, treatment for TACO depends on the severity.
Examples of delayed transfusion reactions include the following: Delayed hemolytic or delayed serologic transfusion reactionA delayed hemolytic or delayed serologic transfusion reaction occurs when an antibody that the recipient already has reforms and reacts to red cell antigens. Reactions can occur between 1 day and 4 weeks after the transfusion. A person can acquire these antibodies through previous pregnancies or transfusions. These particular antibodies decrease over time to undetectable levels. Those with the antibodies have a higher chance of developing these transfusion reactions. SymptomsSymptoms typically include:
TreatmentAccording to LabMedicine, these transfusion reactions tend to be mild and do not require treatment. If the reaction is significant, hydration is important. Transfusion-associated graft versus host disease (TAGVHD)According to the CDC, TAGVHD occurs when T-lymphocytes, a type of white blood cell, from the donor blood rapidly increase in number in the recipient. They then attack the recipient’s cells. However, it is a very rare occurrence, and it has become less prevalent since the introduction of the irradiation of blood products. Blood irradiation involves exposing the blood components to ultraviolet light. SymptomsAccording to the CDC , symptoms include:
TreatmentDoctors find TAGVHD challenging to treat, and as a result, mortality rates are between 90–100%.
Posttransfusion purpura (PTP)The CDC state that PTP is rare. It occurs when the recipient develops antibodies against the platelets. This results in the destruction of platelets and a decline in platelet numbers. SymptomsAccording to a 2019 article, symptoms of PTP can include:
TreatmentTreatment may include:
The outlook depends on which reaction a person is experiencing. However, serious blood transfusion reactions are uncommon. Healthcare providers, blood banks, and hospitals take many precautions to help reduce the chance of a transfusion reaction from occurring. According to the CDC, doctors transfuse 17.2 million blood product units each year in the United States, and most people do not experience any blood transfusion reactions. If someone has a blood transfusion and experiences symptoms, such as shortness of breath, low blood pressure, red or brown urine, flank pain, or other serious side effects, they should see a doctor immediately. Which antihypertensive drugs cause hemolytic anemia?The mechanistic basis for antihypertensive medication‐related changes in hemoglobin concentration include hemodilution, hemolytic anemia, and suppression of red blood cell production, as this occurs most commonly with angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers.
Can antibiotics cause hemolytic anemia?Drug-induced immune hemolytic anemia (DIIHA) is a rare cause of anemia. It is often difficult to distinguish from other causes of hemolytic anemia, thereby delaying diagnosis and treatment. Antibiotics, including penicillins and cephalosporins, are the drugs most often implicated in the development of DIIHA.
What is associated with hemolytic anemia?Two common causes of this type of anemia are sickle cell anemia and thalassemia. These conditions produce red blood cells that don't live as long as normal red blood cells.
How do sulfonamides cause hemolytic anemia?Sulfonamides rarely have adverse effects on erythrocytes. However, there are various mechanisms by which sulfonamide-induced hemolytic anemia can occur (61): abnormally high blood concentrations, due to large doses or reduced excretion of the drug in patients with renal disease (62)
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