A six year old boy who is severely allergic to peanuts had a blood transfusion. This triggered an allergic reaction. It turned out that some of the blood donors ate peanuts the night before they donated blood. This brings up a lot of questions about the safety of blood transfusions for kids who have severe food allergies.
The situation happened in the Netherlands, last year, with a six year old boy who had leukemia. He received a transfusion of pooled platelets as part of treatment. Soon after receiving the blood transfusion, he developed a rash, his skin started swelling, his blood pressure dropped and he started to have trouble breathing. Doctors used a shot of adrenaline to resuscitate the little boy.
Health care workers then tried to figure out what caused this reaction in the boy. They noted that he was not allergic to any of the drugs he had been given, and that he also wasn’t allergic to latex. They went over some common transfusion related problems, and decided that those things were not what caused the reaction, either.
They then spoke to the boy’s mother, who recalled that he had a similar physical reaction after he ate some peanuts when he was one years old. Since that time, she kept all nuts out of her son’s diet. The boy had a severe allergy to peanuts. The doctors then tracked down the five people who had contributed platelets that were transfused into the boy. Three out of five people said that they had eaten handfuls of peanuts the night before they donated blood.
This case study may very well be the first of it’s kind. It is published in the New England Journal of Medicine, and it raises interesting questions about whether or not allergens have been transmitted by blood more often than people have realized.
The thing that people who have peanut allergies are most allergic to is something called Ara h2. It is a natural part of the peanut that is extremely resistant to digestion. This is due to a peptide in it, which can show up in the blood serum for up to 24 hours after a person eats peanuts. In this specific case, doctors tested the boy’s blood, after the transfusion, and they found high levels of peanut-specific antibodies and the peptide. Doctors take this to mean that the donors who ate peanuts actually “gave” the allergen to the boy.
Cases like this one are rare, however. Around 25 million blood components are transfused in the United States every year. It is estimated that around 3 million Americans have an allergy to peanuts or other tree nuts. In other words, it is unlikely that a situation like what happened with this six year old boy will happen to your child. Even so, it’s always a good idea to let your child’s doctors know about your son’s or daughter’s allergy to peanuts.
Image by cyclonebill on Flickr