Which symptoms are associated with a hemolytic blood transfusion reaction?

• A. Only fever
• B. Rash and itching
• C. Shortness of breath only
• D. Increased anxiety, tachycardia, chest pain, fever, chills

Answer: (D)

Hemolytic transfusion reaction happens when donor red cells are destroyed in the recipient due to incompatibility, causing intravascular hemolysis and a rapid inflammatory and cardiovascular response. This leads to fever with chills, a fast heartbeat, chest pain from stress on the heart or ischemia, and anxiety as perfusion worsens. The combination of these systemic signs is characteristic because it reflects both the inflammatory release from destroyed red cells and the resulting hemodynamic strain. Rash and itching point more to an allergic transfusion reaction, while fever or shortness of breath alone can occur with other reactions; the full cluster of fever, chills, tachycardia, chest pain, and anxiety best fits a hemolytic reaction. If such a reaction is suspected, stop the transfusion and seek urgent medical care.