A 19-year-old woman is brought to the emergency department after a motor vehicle collision. The patient's medical history includes celiac disease and 3 episodes of pneumonia. Her blood pressure is 80/45 mm Hg and pulse is 130/min. Physical examination reveals pallor, and ultrasound shows a splenic laceration. She receives a blood transfusion with O-negative packed red blood cells. During transfusion, the patient develops facial swelling, generalized hives, and shortness of breath. Which of the following is the most likely diagnosis in this patient?

Question

A 19-year-old woman is brought to the emergency department after a motor vehicle collision.  The patient's medical history includes celiac disease and 3 episodes of pneumonia.  Her blood pressure is 80/45 mm Hg and pulse is 130/min.  Physical examination reveals pallor, and ultrasound shows a splenic laceration.  She receives a blood transfusion with O-negative packed red blood cells.  During transfusion, the patient develops facial swelling, generalized hives, and shortness of breath.  Which of the following is the most likely diagnosis in this patient?

Quizplus · Accepted Answer

Eductional Objective: Selective IgA deficiency is the most common primary immune deficiency and can present with recurrent sinopulmonary and gastrointestinal infections as well as autoimmune disease.  Patients with severe IgA deficiency can have anaphylaxis during transfusion of blood products that contain small amounts of IgA.

A 19-Year-Old Woman Is Brought to the Emergency Department After