The passive transfer of clinically important nut allergy by the transfusion of fresh frozen plasma (FFP) has, to our knowledge, never before been documented. We report a case of peanut anaphylaxis in a nonatopic recipient of leukocyte-depleted FFP collected from a peanut-allergic donor.
In preparation for gastrointestinal endoscopy, a nonatopic 80-year-old woman receiving long-term warfarin therapy was given a transfusion of 2 U of leukoreduced FFP because her preoperative international normalized ratio was 1.3 (normal range, 0.8-1.2). Two days later, she ate a muffin and some peanut butter and, within minutes, developed throat tightness, dyspnea, dysphagia, and a pruritic rash. Her oxygen saturation was 88%. Aerosolized racemic epinephrine and intravenous corticosteroids were administered, and her symptoms resolved within several hours. She had never before had an allergic reaction to peanuts.
Arnold DM, Blajchman MA, DiTomasso J, Kulczycki M, Keith PK. Passive Transfer of Peanut Hypersensitivity by Fresh Frozen Plasma. Arch Intern Med. 2007;167(8):853-854. doi:10.1001/archinte.167.8.853