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March 1958

Prevention of Nonhemolytic Blood Transfusion Reactions with an Antihistamine, Chlorpheniramine: Report of 6131 Cases

AMA Arch Surg. 1958;76(3):379-383. doi:10.1001/archsurg.1958.01280210049009

Approximately 4,000,000 blood transfusions are given annually in the United States.1 This widespread use of fresh and stored whole blood has focused increasing attention on the prevention and treatment of transfusion reactions.

Pyrogenic reactions occur most frequently2-7 and are characterized by chills, fever, vomiting, nausea, and, in severe cases, prostration. They are caused by exogenous pyrogens introduced by the donor's blood or by contaminated transfusion equipment.8

Allergic reactions, next in frequency, include urticaria, angioneurotic edema, dyspnea, asthma, and, occasionally, anaphylactic shock. They are caused by the release of histamine to its receptor site in the cells. This has been confirmed by Muñoz-Baratta,9 who was able to produce the allergic type of transfusion reactions by injections of histamine. Winter and Taplin10,11 believe that allergic reactions to transfusion are 10 times as frequent among patients with a history of allergy; however, in earlier experiments, De Gowin and