Febrile Nonhemolytic Reactions
PATHOPHYSIOLOGY: For such miserable little nuisance reactions, Febrile Nonhemolytic Reactions have caused quite a stir in Transfusion Medicine research.
As our knowledge of the FNH has improved through extensive research, several things have become clear: First, that it is really not appropriate to refer to these reactions as a single entity, because they can occur in at least two well-described different ways; second, strategies for prevention of these reactions (discussed later) will be different depending on which mechanism actually causes the reaction; and third, that researchers care much more about ridiculous trivial details than I do (no offense intended, by the way, but some of the information that comes out about this or that cytokine or neutrophil priming agent assists me in absolutely no way in helping take care of patients!).
Anyway, all derogatory comments about researchers aside (I'll try to behave), let's begin by breaking the FNH down into two major types. They have been referred to as the "Red Cell FNH" and the "Platelet FNH", and I can't do any better than that. We'll discuss them in turn.
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