Transfusion-related acute lung injury--a report of two and the possible role of steroid.

Transfusion-related acute lung injury (TRALI) is a rare but potentially fatal clinical syndrome associated with transfusion. Dyspnea, hypoxemia, hypotension, and fever are the typical symptoms which mimic those of the adult respiratory distress syndrome (ARDS). The onset of TRALI is usually within 4-6 hours after transfusion. According to literature, TRALI is possibly underdiagnosed and underreported. Differential diagnosis includes fluid overload, allergy and sepsis. No definite protocol except supportive treatment is recommended up to now. We present two cases of TRALI and discuss the possible mechanisms and the role of steroid therapy.