II.e
Transfusion-related acute lung injury (TRALI) (May cause ARDS)
(Fr: OAP transfusionnel. A distinguer de l'OAP de surcharge). TRALI is a distinctive form of ARDS or NCPE (see under IIa, IIb) due to transfusion/infusion of allogeneic blood, platelets, stem-/marrow cells, IVIG or FFP. Typically, TRALI develops within 6-8h of transfusion. Examination of each donor in the pool (more often a multiparous woman) for the presence of pathogenic antibodies to a cognate Ab in the recipient is indicated to prevent further TRALI in other recipents, and the bloodbank shoulb be notified. The syndrome is underappreciated and is amenable to risk reduction strategies (e.g. men-only donor poliicy, Ab screening). TRALI (PMID 25611652) must me differentiated from TACO (Transfusion Associated Circulatory Overload: PMID 17898575, 24360126, 25611653). Predisposing risk factos may account for posttransfusion ARDS also known as 'possible TRALI' (PMID 25488517). Prevention at PMID 30197000
Causative drugs
9
Antiplatelet agents: Glycoprotein IIb/IIIa inhibitors
II.e
II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.c III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.c - Hemoptysis VIII.q VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.q - Tongue involvement (edema, glossitis, hematoma) IX.x IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.x - Thoracic epidural or spinal hematoma
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.c III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.c - Hemoptysis VIII.q VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.q - Tongue involvement (edema, glossitis, hematoma) IX.x IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.x - Thoracic epidural or spinal hematoma
3
Fresh frozen plasma
II.b
II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) II.h II - Pulmonary edema - Acute lung injury - ARDS
II.h - Overload pulmonary edema (including posttransfusional (TACO)) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH)
II.b - ARDS - Acute lung injury II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) II.h II - Pulmonary edema - Acute lung injury - ARDS
II.h - Overload pulmonary edema (including posttransfusional (TACO)) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH)
2
Hemotherapy (transfusion/infusion of whole blood, red cells, platelets, or blood products)
I.l
I - Interstitial/parenchymal lung disease
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) II.f II - Pulmonary edema - Acute lung injury - ARDS
II.f - Hypoxemia, low oxygen saturation (may occur in isolation) II.h II - Pulmonary edema - Acute lung injury - ARDS
II.h - Overload pulmonary edema (including posttransfusional (TACO)) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism VI.i VI - Pulmonary vasculopathies
VI.i - Acute pulmonary hypertension VI.n VI - Pulmonary vasculopathies
VI.n - Crystal pulmonary embolism VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XI.d XI - Miscellaneous
XI.d - Metabolic acidosis (incl. lactic acidosis/-gap). May cause hyperpnea/dyspnea XI.n XI - Miscellaneous
XI.n - Neutropenia, agranulocytosis (w/wo infection/sepsis) XII.j XII - Cardiovascular involvement / toxicity
XII.j - Myocardial stunning XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.w XV - Pathology
XV.w - Path: Pulmonary edema (see also II/IIa) XV.aj XV - Pathology
XV.aj - Path: Cholesterol crystal embolism XV.at XV - Pathology
XV.at - Path: Pulmonary capillary granulocyte sequestration XVI.d XVI - Imaging
XVI.d - Imaging: Alveolar opacities or haze with a batwing or butterfly distribution XVII.ad XVII - Infections & related conditions
XVII.ad - Systemic infection (transmitted)
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) II.f II - Pulmonary edema - Acute lung injury - ARDS
II.f - Hypoxemia, low oxygen saturation (may occur in isolation) II.h II - Pulmonary edema - Acute lung injury - ARDS
II.h - Overload pulmonary edema (including posttransfusional (TACO)) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism VI.i VI - Pulmonary vasculopathies
VI.i - Acute pulmonary hypertension VI.n VI - Pulmonary vasculopathies
VI.n - Crystal pulmonary embolism VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XI.d XI - Miscellaneous
XI.d - Metabolic acidosis (incl. lactic acidosis/-gap). May cause hyperpnea/dyspnea XI.n XI - Miscellaneous
XI.n - Neutropenia, agranulocytosis (w/wo infection/sepsis) XII.j XII - Cardiovascular involvement / toxicity
XII.j - Myocardial stunning XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.w XV - Pathology
XV.w - Path: Pulmonary edema (see also II/IIa) XV.aj XV - Pathology
XV.aj - Path: Cholesterol crystal embolism XV.at XV - Pathology
XV.at - Path: Pulmonary capillary granulocyte sequestration XVI.d XVI - Imaging
XVI.d - Imaging: Alveolar opacities or haze with a batwing or butterfly distribution XVII.ad XVII - Infections & related conditions
XVII.ad - Systemic infection (transmitted)
5
Immunoglobulins, intravenous (IVIG)
II.a
II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) XII.e XII - Cardiovascular involvement / toxicity
XII.e - Takotsubo (stress) cardiomyopathy XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) XII.e XII - Cardiovascular involvement / toxicity
XII.e - Takotsubo (stress) cardiomyopathy XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension
3
Status post-hematopoietic stem cell (HSCT) or bone marrow transplantation (BMT)
I.b
I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.n I - Interstitial/parenchymal lung disease
I.n - Pulmonary alveolar proteinosis (PAP) I.v I - Interstitial/parenchymal lung disease
I.v - Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence I.x I - Interstitial/parenchymal lung disease
I.x - Pleuroparenchymal fibroelastosis (PPFE) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) II.n II - Pulmonary edema - Acute lung injury - ARDS
II.n - Engraftment syndrome III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) IV.m IV - Airway involvement
IV.m - Bronchial stenosis/stricture V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension X.c X - Systemic/Distant conditions, syndromes and reactions
X.c - Capillary leak syndrome (CLS) XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.d XV - Pathology
XV.d - Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.ak XV - Pathology
XV.ak - Path: Pulmonary veno-occlusive disease (PVOD) XV.ap XV - Pathology
XV.ap - Path: Pleuroparenchymal fibrosis/fibroelastosis (PPFE) XV.bv XV - Pathology
XV.bv - Path: Pulmonary cytolytic thrombi XVI.w XVI - Imaging
XVI.w - Imaging: Lung nodule or nodules XVII.m XVII - Infections & related conditions
XVII.m - Fungal airway infection
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.n I - Interstitial/parenchymal lung disease
I.n - Pulmonary alveolar proteinosis (PAP) I.v I - Interstitial/parenchymal lung disease
I.v - Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence I.x I - Interstitial/parenchymal lung disease
I.x - Pleuroparenchymal fibroelastosis (PPFE) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) II.n II - Pulmonary edema - Acute lung injury - ARDS
II.n - Engraftment syndrome III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) IV.m IV - Airway involvement
IV.m - Bronchial stenosis/stricture V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension X.c X - Systemic/Distant conditions, syndromes and reactions
X.c - Capillary leak syndrome (CLS) XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.d XV - Pathology
XV.d - Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.ak XV - Pathology
XV.ak - Path: Pulmonary veno-occlusive disease (PVOD) XV.ap XV - Pathology
XV.ap - Path: Pleuroparenchymal fibrosis/fibroelastosis (PPFE) XV.bv XV - Pathology
XV.bv - Path: Pulmonary cytolytic thrombi XVI.w XVI - Imaging
XVI.w - Imaging: Lung nodule or nodules XVII.m XVII - Infections & related conditions
XVII.m - Fungal airway infection
2
Stem cell infusion/transplantation
II.b
II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH)
II.b - ARDS - Acute lung injury II.e II - Pulmonary edema - Acute lung injury - ARDS
II.e - Transfusion-related acute lung injury (TRALI) (May cause ARDS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH)
1