Dr. Rodriguez orders 250 milliliters of packed red blood cells (RBC) for a patient. This therapy is administered for the treatment of:
A. Thrombocytopenia
B. Leukopenia
C. Anemia
D. Hypoalbuminemia
Correct Answer: C. Anemia
A red blood cell transfusion is used to correct anemia in patients in which the low red blood cell count must be rapidly corrected. Red blood cell transfusions may be given to patients with severe iron-deficiency anemia who are actively bleeding or have significant symptoms such as chest pain, shortness of breath, or weakness. Transfusions are given to replace deficient red blood cells and will not completely correct the iron deficiency.
Option A: RBC transfusion will not correct a low platelet count. Thrombocytopenic emergencies that require immediate action includes conditions of suspected HIT, TTP, HUS, drug-induced ITP, pregnancy with severe thrombocytopenia, bleeding with severe thrombocytopenia, urgently needed an invasive procedure in the presence of severe thrombocytopenia, leukopenia, and aplastic anemia. In patients with bleeding and severe thrombocytopenia, treatment includes platelet transfusion. Management includes identifying the underlying cause and treating it.
Option B: RBC transfusion will not correct a low white blood cell count. Application of granulocyte-colony stimulating factor (G-CSF) can improve neutrophil functions and number. Prophylactic use of antibiotics and antifungals is reserved for some forms of alteration in neutrophil function such as chronic granulomatous disease CGD). The utilization of antimicrobials is compulsory if recurrent infections exist. Interferon-gamma has been successfully used to improve the quality of life of the patient suffering from neutropenia. Allogenic bone marrow transplantation from an HLA-matched related donor can cure CGD but has a high mortality rate, and gene therapy is also a therapeutic option for treating disorders with neutropenia. Furthermore, intravenous immunoglobulins can be another option in the management of these disorders.
Option D: Packed RBCs contain very little plasma, and thus, only a small amount of albumin. This amount will not correct low albumin levels. Treatment is directed at the cause of hypoalbuminemia since it is a consequence of some disease. In the critically ill, in particular, burn patients, albumin infusions may be given. It is controversial whether albumin infusions are of clinical benefit to other groups of critically ill patients. It also has some value in patients with cirrhosis with certain complications