Leitman et al reported patients who developed allergic symptoms following plasmapheresis using equipment sterilized in ethylene oxide gas. Similar reactions have been reported in patients undergoing hemodialysis. Ethylene oxide may remain on certain plastics after the sterilization process, and some may be infused in with the blood product.


Clinical features:

(1) infusion of blood or plasma through intravenous equipment sterilized in ethylene oxide

(2) allergic signs and symptoms (see below)

(3) evidence of allergy to ethylene oxide (by skin testing, RAST, basophil histamine release or other method)

(4) no other explanation that can explain the findings better


Signs and symptoms of an allergic reaction may include:

(1) periorbital edema, chemosis, tearing

(2) pruritis

(3) urticaria

(4) rhinorrhea

(5) abdominal cramping

(6) diarrhea

(7) anaphylaxis


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