Can Platelet Transfusions Trigger Severe Reaction in
Those With Peanut Allergies?05/18/11
WEDNESDAY, May 18 (HealthDay News) -- A boy with a peanut
allergy had a severe reaction after receiving a blood platelet
transfusion that may have contained bits of undigested peanut
protein, according to a new case report published in a major
Though the findings suggest that people with nut allergies may
be susceptible to an allergic reaction from blood products, experts
stressed there is no cause for alarm.
Not only does the report document only a single case, the boy
received a platelet transfusion, which contain lots of blood serum
(the liquid components of blood that don't contain red or white
blood cells), explained Dr. Scott Sicherer, chair of the American
Academy of Pediatrics' section on allergy and immunology.
That's different from a typical blood transfusion, in which the
blood is "washed" and only red blood cells are transfused, said
Sicherer, also a researcher at Jaffe Food Allergy Institute at
Mount Sinai School of Medicine in New York City.
"A blood transfusion would have a lot less of the liquid from the bloodstream, and that would presumably mean if there was any peanut in the blood it would have been washed away," Sicherer noted.
The case report was published in the May 18 issue of the
New England Journal of Medicine.
After a person eats nuts, some of the proteins circulate in the
blood, Sicherer said. That's led experts to speculate whether or
not someone with a nut allergy who receive donated blood products
could react to peanut proteins in the blood.
For people with severe peanut allergies, ingesting even tiny
amounts of peanut protein can set off a life-threatening allergic
reaction called anaphylaxis.
But it's premature to encourage blood donors not to eat peanuts
before giving blood or for questions about diet to become part of
the screening process, said the report authors.
"Our case report will not change any of the current protocols surrounding blood donations," said Dr. Johannes F.M. Jacobs, of Radboud University Nijmegen Medical Center in the Netherlands. "Further research is needed before evidence-based decisions on this point can be taken. In our case report, we only wanted to create awareness for this phenomenon among clinicians."
Sicherer agreed that the possibility that peanuts in blood
products -- or other tree nuts or other foods, for that matter --
could cause an allergic reaction is worth further study.
The 6-year-old boy in the case report was being treated for
leukemia and received a platelet transfusion, which helps with
clotting. The boy experienced swelling, low blood pressure and
difficulty breathing, all signs of anaphylaxis. The boys' mother
said he'd had a similar reaction after eating peanuts as a
He was given adrenalin and recovered, according to the
Three of the five platelet donors reported eating several
handfuls of peanuts less than 24 hours before donating blood.
Researchers never actually tested the blood product that the boy
received, but they did test the boy's blood for peanut-specific IgE
antibodies, the results of which indicated the boy had a peanut
allergy. In addition, the boy had other prior platelet transfusions
and had no reaction, Jacobs said.
Peanut proteins are more resistant to digestion that other
foods, according to the authors.
"One percent of the population has peanut allergy and people get blood transfusions all the time," Sicherer said. "Allergic reactions seem to be exceedingly rare if it happens."
Nemours Foundation has more on nut and peanut
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