TRANSFUSION & FEVER

Dear Andy,

My baby is now 19 months old and getting transfusion every 6/7 weeks duration.After getting transfusion always her body temperature increase from 97 to 99 or 100.But this time after complete her transfusion her temperature was raised up to 102.She suffered two days from fever.Now today after 6 days of her transfusion her temperature is again 102 to 103 and some blood has came with her stool.I can't understand is it for food poisoning or another reason.I am also worried to think about her HB also.May be it has reduce for fever.Now I decide to give her anti biotic which may also will be decrease her HB.But what we will do?Please give your opinion and help us pls......

It sounds very much like a reaction to antibodies in the blood. Often, an antihistamine is given before the transfusion to reduce the reaction. Talk to your doctor about this. Antibiotics are not usually called for in this circumstance.

Hello Andy,

Last time my baby was taken transfusion after 60 days when her hb was 9.20.But this time after only 43 days her hb is 8.3.I think its her fever effect.For that we decide tomorrow give her 11th transfusion....Feeling so much sad   and also worried for fever   .According to your advice I will give her antihistamine before the transfusion..

Pray for her....

It's not unusual to see Hb drop if a child has been sick. Don't be too worried. It's something that happens occasionally.

Hello Andy,

Yesterday my baby was taken antihistamine as "Alatrol" before transfusion but no change Andy....When she completed her transfusion then her temperature raise up to 102 over and now her fever is 101.2.From yesterday she suffering from fever and we trying with every thing but its not drop from 101 to 100...Doctor advised "don't worry,it is antibodies reaction".

This is my babies 11th transfusions.After taking Last 2 transfusions she suffered by fever.But earlier transfusions no problem.Why she is now suffering?Is there any health problem?Earlier antibodies not affected but now why?

Andy, in this situation will hb drop for fever?

The more transfusions a patient has, the more the chance of antibody reactions. Perhaps a different antihistamine can be tried, like benadryl. One other possibility is to administer a steroid before the transfusion.

I agree that another antihistamine will be helpful.  It is also very important to determine what antibodies your daughter has developed and to avoid giving her blood with those particular antigens in the future to avoid reactions or fever.

My son also began developing antibodies around the age of two.  Antibodies develop as a reaction to certain antigens - that is why they were not present before.  Don't worry, if doctors avoid giving your daughter blood containing the particular antibodies your daughter has developed she will be fine.

Best,  

Sharmin

Thanks Andy and Sharmin...

For the fever hb level will be drop or not ?

It's difficult to predict Lokkhi maa, sometimes it does and sometimes it doesn't. 

Dear Andy,

My baby has already taken 11 transfusions in her 22 months old and she suffered from fever last 2 times after taking transfusion from the new two persons who are not donate her earlier.

Andy,if my baby again take transfusion from them then the same problem will be arise or not? I am really confused and also worried for her next transfusion. Whats your decision this time I give my baby  benadryl to avoid the fever?

Yes, try benadryl before the transfusion begins.

Dear Andy,

Only 1 dose before transfusion ? Next dose ??

In Canada, the doctors usually give one dose of Benadryl before transfusion. No dose after the transfusion. This is just precautionary measure. If the fever persists after transfusion, check with the doctor for guidance.

Hello Canadian_Family,

Thank you for your reply.Last time I was given my baby 5 ml Alatrol before 2 hours of transfusion.During transfusion no problem but after completion fever was 101 to 102...

For that this time I am confused what will we do? Could  my baby take transfusion in future from those donators by whom she got fever after transfusion ....

Please advice..

I would investigate the underlying cause of fever after transfusion (see if your child has developed antibodies that reacts to antigenes). If you have donors from same group of people, you may choose to switch the donors and see if the fever is gone.

Sometimes, antibodies in the recipient’s blood can attack the donor blood if the two are not compatible (this may be the case for your child). If the recipient’s immune system attacks the red blood cells of the donor, it is called a hemolytic reaction. If the recipient’s immune system attacks the white blood cells of the donor blood, it is called a febrile reaction. In haemolytic reaction, the haemoglobin drops quickly requiring frequent blood transfusion. In febrile reaction, the symptoms include fever.

Do you mind sharing if the fever was accompanied by chills and shaking in your child.

Try switching the donor as first step.

Ask your doctor if a different antihistamine is required.