Peanut Allergy and a Transfusion Reaction

Important news for anyone giving the gift of life: food allergens can affect blood transfusions. The letter to the editor in The New England Journal of Medicine on May 19, 2011, Anaphylaxis from Passive Transfer of Peanut Allergen in a Blood Product , describes how a 6 year-old boy with Leukemia developed a severe allergic reaction after a transfusion with blood platelets.

Transfusion reactions are rare, and are usually avoided with careful screening of ABO blood compatibility. The mother made the keen observation that the only time her son had a similar reaction was at age 1 when he ate some peanuts, and the family had since been very careful to avoid any peanut ingestion by their son. The physicians were astute in locating the multiple blood donors of the platelets (blood clotting particles) in this case.

With careful questioning the donors did recall eating peanuts the night before they gave their blood! How could this affect the young boy with Leukemia? It turns out peanut proteins can stay in the blood for 24 hours after ingested. The blood donated by these individuals was measured and found to have circulating peanut proteins. The young boy’s blood was tested and showed he had high levels of IgE (the allergy) antibody to peanut protein. This is the first time a reaction like this has ever been reported and linked to a food allergen.

The take home message: Peanut allergy is clearly on the rise, and to anyone generous enough to donate blood to help save another person, please avoid eating peanuts for at least a week before the donation.

As an NY allergist, I know that peanut allergic parents don’t need one more thing to worry about, but I think this information is useful and if there is a concern, they may want to ask donors, family and friends if they have avoided peanuts before donating blood. Contact us with any questions you may have, or to have a food allergy treatment in NY.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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