Caitlin Raymond: When the Textbook Walks Through the Door
Caitlin Raymond, Assistant Professor of Pathology and Transfusion Medicine at University of Wisconsin-Madison, shared on LinkedIn:
”When the Textbook Walks Through the Door
We recently reviewed a patient with a drifting hemoglobin and a “Requires washed RBCs” flag in the chart. On review, the patient had a complete IgA deficiency (IgA < 5 mg/dL on two occasions) — but no history of reactions.
It’s a scenario drilled into every pathology board prep book: IgA-deficient patient, life-threatening anaphylaxis, washed components only.
But outside the exam room, that story is rarely seen.
Anti-IgA–mediated anaphylaxis is exceedingly rare. Only isolated cases are described in the literature, and even among those with anti-IgA antibodies, many tolerate blood products and immunoglobulin infusions without issue. The link between anti-IgA and anaphylaxis remains controversial — likely modulated by factors we don’t yet understand.
Sometimes our most deeply ingrained “never forget” lessons are exactly the ones worth re-examining.
Read the full post: When the Textbook Rarely Walks Through the Door: IgA Deficiency and Transfusion Practice.”
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