輸血誘發急性肺損傷－－兩病例報告與類固醇之可能角色

Transfusion-related Acute Lung Injury-- A Report of Two Cases and the Possible Role of Steroid

輸血誘發急性肺損傷是一種罕見但可能致命之輸血症候群。常見的症狀有呼吸困難、缺氧、低血壓及發燒等等，有時與成人急性呼吸窘迫症難以區別。輸血誘發急性肺損傷通常在輸血後四至六小時之內發生。鑑別診斷包括輸液過量、過敏反應及敗血症等。我們報告兩病例並探討類固醇在治療輸血誘發急性肺損傷之可能角色。

Transfusion-related acute lung injury (TRALI) is a rare but potentially fatal clinical syndrome associated with transfusion. Dyspnea, hypoxemia, hypotension, and fever are the typical symptoms which mimic those of the adult respiratory distress syndrome (ARDS). The onset of TRALI is usually within 4-6 hours after transfusion. According to literature, TRALI is possibly underdiagnosed and underreported. Differential diagnosis includes fluid overload, allergy and sepsis. No definite protocol except supportive treatment is recommended up to now. We present two cases of TRALI and discuss the possible mechanisms and the role of steroid therapy.