article · Journal of Medical Case Reports
Blood transfusions are frequently required to manage anaemia caused by cancer and its treatments, but they carry risks of adverse reactions. A 51-year-old man with castration-resistant prostate cancer and severe anaemia experienced an isolated ocular surface reaction during a packed red-cell transfusion. After receiving approximately 250 millilitres of blood, the patient developed acute bilateral eye pain, photophobia, and conjunctival swelling covered by thick mucus. Major systemic complications were ruled out because the patient showed no fever, chills, low blood pressure, respiratory distress, abdominal pain, jaundice, or altered urine colour. The transfusion was stopped immediately, and treatment with intravenous and topical steroids was initiated. The patient achieved complete resolution of all ocular signs and symptoms within eight hours and was discharged the following day. Standardised management protocols for this rare reaction currently do not exist.
Blood transfusions are essential supportive therapies in cancer care, but adverse effects can occasionally present in unusual ways without typical signs like fever or breathing distress. Recognising rare isolated ocular reactions allows healthcare providers to intervene promptly by halting transfusions and administering steroids, preventing unnecessary complications and promoting rapid recovery even in the absence of standardised treatment protocols.
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Cancer treatments, such as surgery, chemotherapy, and radiotherapy, as well as cancer itself, commonly result in anemia. As a result, patients frequently require blood transfusions to maintain an optimal hemoglobin level. However, blood transfusion has its own set of adverse reactions, which can range from minor to life-threatening complications, such as hemolytic transfusion reaction, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO). The exact incidence of transfusion reactions in cancer patients is not well-known. In earlier reports, the overall incidence is 0.3%. However, to the best of the author’s knowledge, there is no published report of isolated ocular blood transfusion reaction in Ethiopia. Here, we report the presentation of an infrequent adverse event and its management. A 51-year-old man with castration-resistant prostate cancer and severe anemia (hemoglobin concentration of 6.2 g/dl). Packed red-cell transfusion was started after grouping and cross-matching. After about 250 ml of the blood had been transfused, he suddenly felt severe pain and discomfort in both eyes, with associated photophobia and conjunctival edema. Ocular examination revealed edematous and engorged conjunctivae with thick mucinous coverage. The rest of the examinations were non-revealing. Based on the absence of fever, chills, hypotension, respiratory distress, abdominal pain, jaundice, or change in the urine color on this presentation, acute hemolytic transfusion reaction, TACO, and TRALI were considered clinically unlikely. Transfusion was immediately discontinued; intravenous and topical steroid was applied. Signs and symptoms resolved completely within 8 h and was discharged home the following day after observation. We have reported a probable case of isolated ocular surface blood transfusion reaction. Despite the fact that this complication is extremely rare. Prompt discontinuation of transfusion and administration of systemic and topical steroids led to rapid resolution; however, no standardized protocol exists for this rare entity.
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DOI: 10.1186/s13256-026-06474-1
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