• V Betbèze, A Cottereau, G Bourreille, J-D Bignon, A Masseau, J-Y Muller, and M Hamidou.
• Unité d'Hémovigilance, CHU Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes, France.
• Rev Med Interne. 2007 Jul 1; 28 (7): 498-500.

IntroductionTransfusion-related acute lung injury is a post-transfusion interstitial lung injury.Case ReportWe reported a post-transfusion acute lung injury in a 23-years old woman having a chronic thrombotic microangiopathy related to an ADAMTS 13 constitutional deficiency receiving monthly plasma infusion for six years. The temporal relationship between the lung injury and the infusion of fresh frozen plasma led to the diagnosis of transfusion-related acute lung injury. The finding in the donor of the transfused plasma of an anti-HLA class II antibody recognizing HLA-DR52 present on leucocytes of the recipient suggests a causal relationship between this antigen-antibody conflict and the triggering of the TRALI. This chronic pathologic state requiring monthly plasma transfusions for thrombotic accident prevention raises the question of the selection of plasma obtained from non-immunized donors.ConclusionThe occurrence of a post transfusion pulmonary edema without cardio-vascular overload, must lead to consider a TRALI especially in predisposing clinical situations. In the case reported the role of constitutional ADAMTS 13 deficiency in genesis of TRALI is considered.

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