Acute & emergency · UKMLA & AKT

Allergic and anaphylactic transfusion reactions

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise allergic and anaphylactic transfusion reactions — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Symptoms begin within minutes of starting transfusion (sometimes after only a few millilitres)
  • Anaphylaxis: urticaria, angioedema, bronchospasm/wheeze, hypotension, tachycardia - typically NO fever or haemoglobinuria
  • Mild allergic reaction: urticaria only, haemodynamically stable

Fever + haemoglobinuria + back/flank pain + hypotension = acute haemolytic reaction, NOT anaphylaxis. Abdominal/chest/loin pain during transfusion also points to acute haemolytic reaction. These require fundamentally different management.

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