How I manage patients suspected of having had an IgA anaphylactic transfusion reaction

ransfusions of plasma-containing blood components may be associated with a variety of allergic-type reactions, ranging from a few hives to life-threatening laryngospasm or anaphylaxis. In the latter case, the possibility of anti-IgA-mediated anaphylaxis is often included in the differential diagnosis, but diagnostic and therapeutic options are limited. Testing for anti-IgA is available in only a few reference laboratories and supplies of frozen IgA-deficient plasma are in limited supply. Below, I offer an approach to the management patients in this clinical situation for the new TRANSFUSION feature series “How Do I . . . ?”