Severe transfuse related acute lung injury (TRALI) syndrome in a 14 years old girl with a history of type I von Willebrand disease

Pneumologia. 2012 Jul-Sep;61(3):175-7.

Abstract

Von Willebrand disease (vWD) is the most common inherited bleeding disorder based on an autosomal abnormality of von Willebrand factor. Transfusion is a lifesaving medical intervention among patients with bleeding disorders. Patients with vWD are exposed to Transfuse Related Acute Lung Injury (TRALI) when they become recipients of multiple blood products and repeated transfusions. TRALI is a non-hemolytic transfusion reaction induced by infusions of intravenous immunoglobulin, platelets (suspended in plasma), whole blood, cryoprecipitates, and fresh frozen plasma (FFP). We report a 14 years old white girl, with a history of type 1 von Willebrand disease (vWd), recipient of 2 units' fresh-frozen plasma (FFP) and 1 unit whole blood transfusion who developed an acute respiratory distress with severe hypoxemia and bilateral pulmonary infiltrate on chest X-ray within 3 hours of the whole blood transfusion, completely reversible after mechanical ventilation. Concluding, patients with vWd who received recurrent transfusions have an increased risk of TRALI. Physicians must be familiar with it as a cause of white lung X-ray pattern.

Publication types

  • Case Reports

MeSH terms

  • Acute Lung Injury / etiology*
  • Acute Lung Injury / therapy
  • Adolescent
  • Diagnosis, Differential
  • Female
  • Humans
  • Respiration, Artificial
  • Syndrome
  • Transfusion Reaction*
  • Treatment Outcome
  • von Willebrand Disease, Type 1 / complications*
  • von Willebrand Disease, Type 1 / therapy