Management of adverse transfusion reactions Rheumatoid How to deal with reactions after taking the d

, Patient: Description of the condition (onset time, main symptoms, hospital, etc.): Male age, one year ago, facial erythema, sometimes low-grade fever, local hospital diagnosis Some doctors diagnosed, with prednisone mg days, no obvious change after a month, *** obvious, after gradually stopping prednisone, change hydroxychloroquine mg days, nothing else during the medication, often check the blood are normal, but a little fatigue, **a little darkened, after a month, the facial erythema completely subsided, that is, after stopping the drug, purpura appeared on both calves after half a month Q:

Is purpura caused or hydroxychloroquine? Should hydroxychloroquine be used for this disease, and will the dose be large? (mg per day per month) to see the youngest on the Internet with age, is it not turned over, look at the Internet said that the boy's performance is not typical There is a can be turned into the next step**?

Wang Jinping, Department of Rheumatology and Immunology, Gansu Provincial People's Hospital, Department of Immunology and Rheumatology, Gansu Provincial People's Hospital: DLE: discoid lupus erythematosus; sle：

Systemic lupus erythematosus. Suggestion: Reliable rheumatology and immunology department of a major hospital, systematic examination, diagnosis and identification of the disease, severity, and scope of influence, reasonable, effective and safe follow-up**.

Systemic lupus erythematosus should be considered if purpura develops in both calves after half a month, sometimes low-grade fever, and there are already manifestations of vascular or hematologic involvement. View the original post

As an important part of Abbott's plan to spin off the branded drug business, Abbott Life (abbvie) will go public in the United States as an independent company on January 2 next year. The majority of the company's sales are expected to be in adalimumab (rheumatoid arthritis) with annual sales of nearly $9 billion, while the company will also have a pipeline of Abbott's drug candidates and gradually reduce its reliance on adalimumab sales. View the original post

A few small prescriptions for foot soaking in mugwort leaves: 1Wormwood and ginger can treat cold, arthropathy, rheumatoid, cough, bronchitis, emphysema and asthma.

2.Wormwood plus safflower can improve varicose veins, peripheral neuritis, poor blood circulation, numbness or bruising of the hands and feet. View the original post

Generally, after a slight cessation of blood transfusion, it will gradually improve!

Severe hospitals will treat the symptoms**!

Adverse reactions to blood transfusion should be handled according to the following procedures: immediately stop blood transfusion, change to isotonic saline, maintain venous access, first report to the physician on duty or the treating physician, and take corresponding examinations and measures as soon as possible.

If chills and fever are predominantly present, without a drop in blood pressure, it may be a febrile reaction. Antipyretic sedatives can be given, and symptomatic treatment can be given, such as keeping warm during chills and physical cooling during fever;

If the presentation is urticaria, **flushing and itching, and generally no drop in blood pressure and fever, it may be an allergic reaction, and antihistamines and sedatives can be given. Most of them can be relieved, and some cases are accompanied by dyspnea, asthma, laryngeal edema, and decreased blood pressure (note that it is distinguished from pulmonary edema caused by circulatory overload, which is jugular venous distention, a large amount of frothy sputum, most of the patients are young children or the elderly, cardiopulmonary insufficiency) or even anaphylactic shock, treated as anaphylactic shock, and laryngeal intubation or tracheotomy if necessary;

If pulmonary edema is present, blood and fluid transfusions should be stopped immediately. Semi-sitting, limbs take turns to tie the m-belt, oxygen inhalation, diuresis. Bloodletting if necessary;

Hemolytic reactions or bacterial contamination should be suspected if symptoms are severe, low back pain (no significant low back pain may be present under anesthesia), a sharp drop in blood pressure, or widespread bleeding from the surgical wound. The blood transfusion department should be notified immediately and reported to the hospital transfusion management committee. A rescue and special care team was quickly set up, and at the same time, blood samples were collected from the recipient and the remaining blood samples in the blood bag for centrifugal observation of the color of the plasma, measurement of free hemoglobin, re-examination of blood grouping, cross-matching test, detection of urinalysis and hemoglobin, bacterial smear and bacterial culture, and drug susceptibility test.

for rapid diagnosis and early treatment. Urine color and output should be closely observed and recorded, if wine or soy sauce hemoglobinuria is subsequently present. or report a blood group error or red plasma, anti-shock and renal function protection measures should be taken as soon as possible to prevent acute renal failure, and urgent exchange transfusion should be taken if necessary

If bacteria are reported on blood smear, the patient has high fever and signs of toxic shock. Anti-shock measures and intravenous infusion of high-dose high-potency antibiotics should be initiated as soon as possible. In severe cases, exchange transfusion may be considered.

Make medical records in a timely manner and properly and permanently keep all kinds of medical records and documents (especially blood transfusion consent forms, blood matching reports and various examination results, etc.).

Personally, I think -- there should be a k of blood in the bank

As long as the test is correct, it's nothing.

Transfusion reactions refer to adverse reactions that occur during or after the transfusion of blood or its products or the infusion equipment used.

Self-transfusion:

The microcirculation of anterior resistance vessels and posterior resistance vessels were constricted, and the microcirculation of anterior resistance vessels showed less perfusion and less flow, and less perfusion than flow. Because the venules and venules constrict, there is a "self-transfusion".

The process of each hospital may be different, but it is basically the same, the first is to stop the blood transfusion, and then carry out the corresponding **, routine examination, such as urine protein, blood routine, plasma free hemoglobin determination and other examinations, and at the same time take heparin anticoagulant blood specimens and fill in the blood transfusion adverse reaction record form and send it to the blood transfusion department for further examination, if bacterial contamination is suspected, take the blood in the blood bag for bacterial culture.

Report to the hospital's medical department in a timely manner.

Hemolysis: Red blood cells break down and hemoglobin escapes called red blood cell lysis, referred to as hemolysis. It can be caused by a variety of physicochemical factors and toxins.

In vitro, such as hypotonic solution, mechanical strong oscillation, sudden low temperature freezing (-20 -25) or sudden thawing, excessive acid or alkali, as well as alcohol, ether, saponine, choline salts, etc. can cause hemolysis. The isotonic solution of human plasma is a solution, and the red blood cells are lower than the solution, and the red blood cells are ruptured due to water infiltration, red blood cell expansion, and hemoglobin escapes. In vivo, hemolysis can be caused by the invasion of hemolytic bacteria or some snake venom, antigen-antibody reactions (such as transfusion of incompatible blood), various mechanical injuries, intrinsic (membrane, enzyme) defects in red blood cells, and certain drugs.

Hemolytic bacteria, such as some hemolytic streptococci and Bacillus perfringens, can cause sepsis. Plasmodium destroys red blood cells and some hemolytic snake venoms contain lecithinase, which converts the lecithin of plasma or red blood cells into lysolecithin, which breaks down the red blood cell membrane.

Instead, type O red blood cells were transfused, blood was drawn for bilirubin testing, urine was taken to see the severity of hemoglobinuria, and other treatment measures were taken.

The first and most urgent thing should be continuous blood transfusion, otherwise the tissues will be deprived of oxygen and the organs will fail rapidly.

Then look for the cause for the next step.