A young donor came to the blood bank for the first time for platelet apheresis with platelet count of 1.9L. During the course he developed paresthesias, circumoral numbness during donation. His vitals remain stable though. ECG showed tachycardia with ST-T changes. What is the reason for his symptoms?
Hypovolemic shock
Hypocalcemia
Seizures
Allergic reaction
Ans. b. HypocalcemiaClinical findings of paresthesias, circumoral numbness and ECG showing tachycardia with ST-T changes are highly suggestive of hypocalcemia, which has been caused by extensive transfusion of citrated blood."Citrate, commonly used to anticoagulate blood components, chelates calcium and thereby inhibits the coagulation cascade. Hypocalcemia, manifested by circumoral numbness and/or tingling sensation of the fingers and toes, may result from multiple rapid transfusions."-H,"Transient hypocalcemia is seen with severe sepsis, burns, acute kidney injury, and extensive transfusions with citrated blood.