Urticarial Reactions
PRESENTATION: Urticarial reactions are also known as "skin-limited allergic reactions," which should give you a clue to how they present.
These reactions may occur at any time during the transfusion (or even afterward), but they usually happen during the first half hour or so, in my experience. The recipient reports an itching sensation, either in the area of the infusion site or all over. This is usually accompanied by redness in the same areas as the itching. Hives are common, but they are not always seen.
In the strictest sense, if you are going to call a reaction "urticarial" or "skin-limited", this is where the symptoms must stop. Additional symptoms such as breathing problems, hypotension, or nausea and vomiting takes a reaction from the simple urticarial designation into a more severe allergic-type reaction. This may lead to more aggressive intervention and/or a more detailed workup.
OK, let's discuss the pathophysiology of the urticarial reaction.
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