Vol. 6, Issue 1, Part A (2024)

Transfusion-related acute lung injury (TRALI) is a serious and potentially fatal complication that can occur after the transfusion of blood products which presents with deteriorating pulmonary symptoms that can ultimately lead to acute respiratory distress syndrome (ARDS). In this case study, we emphasize the importance of detecting TRALI at its early stages to allow for better management and prognosis for the patient. The patient is an 81 year old female who presented with a low hemoglobin of 6.4 and shortness of breath that needed immediate transfusion of packed red blood cells (PRBCs) and empiric antibiotics. In the process of stabilizing the patient, his chest x-ray demonstrated bilateral pleural effusions which at first was perceived to be part of an infectious process. However, the blood transfusion and antibiotics created no improvement in this patient’s shortness of breath or chest x-ray pulmonary findings. The similarities of the symptoms of TRALI to an infectious process is what makes it a complex condition to identify and through discontinuation of the blood products, supportive management, and further work-up the etiology was able to be narrowed down. Being able to better understand the pathogenesis and progression of TRALI will help improve the clinical course of the population of patients that experience adverse events from blood transfusions yearly.