Occasionally a patient may experience severe pain while being transfused with a blood product. The cause of this acute pain transfusion reaction (APTR) is unknown.


Clinical features:

(1) severe pain in back, chest and/or proximal limbs

(2) dyspnea or tachypnea

(3) hypertension

(4) tachycardia

(5) chills

(6) flushing

(7) restlessness


The pain has an abrupt onset while being transfused and resolves shortly after the transfusion is stopped.


The reaction may occur during transfusion of red blood cells or platelets. Most cases have involved products that have been leukocyte reduced prior to storage.


Diagnosis involves exclusion of other kinds of transfusion reaction:


(2) febrile nonhemolytic transfusion reaction

(3) acute hemolytic transfusion reaction

(4) allergic reactions


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