{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:01:02Z","timestamp":1790816462488,"version":"4.1.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transfusion-related acute lung injury (TRALI) and anaphylactic shock are rare but life-threatening transfusion-related complications. Differentiating between these conditions during general anesthesia is difficult because subjective symptoms cannot be assessed and intraoperative diagnostic evaluation is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 40-year-old woman undergoing surgery for ovarian cancer under general anesthesia developed acute hypoxemia during transfusion. After completion of the transfusion, she developed sudden hypotension, tachycardia, and generalized erythema, which responded promptly to adrenaline administration. Respiratory failure persisted, and frothy sputum appeared in the endotracheal tube. Postoperative chest radiography showed bilateral pulmonary infiltrates, while echocardiography revealed preserved cardiac function. Anti-human leukocyte antigen (HLA) class I and II antibodies were detected in the transfused fresh frozen plasma, and serum tryptase levels were elevated postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case demonstrated overlapping clinical features of TRALI and anaphylactic shock during general anesthesia. Although donor anti-HLA antibodies supported the possibility of TRALI, severe anaphylaxis alone could not be completely excluded as an explanation for the pulmonary edema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-026-00867-3","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T14:45:26Z","timestamp":1783176326000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Overlapping clinical features of transfusion-related acute lung injury and anaphylactic shock during general anesthesia: a case report"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7765-9354","authenticated-orcid":false,"given":"Masashi","family":"Inoue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Taniguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"867_CR1","doi-asserted-by":"publisher","first-page":"2465","DOI":"10.1111\/trf.15311","volume":"59","author":"APJ Vlaar","year":"2019","unstructured":"Vlaar APJ, Toy P, Fung M, Looney MR, Juffermans NP, Bux J, et al. A consensus redefinition of transfusion-related acute lung injury. Transfusion. 2019;59:2465\u201376.","journal-title":"Transfusion"},{"key":"867_CR2","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.iac.2022.10.002","volume":"43","author":"K McHugh","year":"2023","unstructured":"McHugh K, Repanshek Z, Anaphylaxis. Emergency Department Treatment. Immunol Allergy Clin North Am. 2023;43:453\u201366.","journal-title":"Immunol Allergy Clin North Am"},{"key":"867_CR3","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1007\/s00540-021-03005-8","volume":"35","author":"Working Group for the Preparation of Practical Guidelines for the Response to Anaphylaxis","year":"2021","unstructured":"Working Group for the Preparation of Practical Guidelines for the Response to Anaphylaxis. Safety Committee of the Japanese Society of Anesthesiologists. Practical guidelines for the response to perioperative anaphylaxis. 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