Yellow urticaria is a rare clinical variant of urticaria characterized by yellowish wheals, typically associated with hyperbilirubinemia. Its occurrence as a transfusion-related reaction is uncommon and may mimic more serious transfusion complications. We report the case of a 15-year-old Saudi female patient who presented with prolonged vaginal bleeding and severe iron deficiency anemia requiring packed red blood cell transfusion. Approximately 15 minutes after transfusion initiation, she developed pruritic yellowish urticarial wheals over the trunk and extremities, without angioedema or hemodynamic instability. Laboratory evaluation revealed mild hyperbilirubinemia, while direct and indirect Coombs tests were negative, and no clinical or laboratory evidence suggestive of hemolysis was identified. The transfusion was temporarily interrupted, and the patient was treated with antihistamines, corticosteroids, and epinephrine, leading to complete resolution of the lesions within 24 hours. Transfusion was later resumed without recurrence. This case highlights transfusion-related yellow urticaria as a benign but rare reaction. Early recognition is essential to avoid misdiagnosis and unnecessary interruption of life-saving transfusion therapy.
Abstract
Case Reports
Journal Article
eng
42037902
Alsemairi, Lana T., et al. "A Rare Case of Yellow Urticaria Developing During Blood Transfusion." Cureus, vol. 18, no. 3, 2026, pp. e105814.
Alsemairi LT, Ahmed A, Ibrahim AI, et al. A Rare Case of Yellow Urticaria Developing During Blood Transfusion. Cureus. 2026;18(3):e105814.
Alsemairi, L. T., Ahmed, A., Ibrahim, A. I., Zaytuni, M., & Aljohani, K. H. (2026). A Rare Case of Yellow Urticaria Developing During Blood Transfusion. Cureus, 18(3), e105814. https://doi.org/10.7759/cureus.105814
Alsemairi LT, et al. A Rare Case of Yellow Urticaria Developing During Blood Transfusion. Cureus. 2026;18(3):e105814. PubMed PMID: 42037902.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - A Rare Case of Yellow Urticaria Developing During Blood Transfusion.
AU - Alsemairi,Lana T,
AU - Ahmed,Azhar,
AU - Ibrahim,Abdurrahman I,
AU - Zaytuni,Mustafa,
AU - Aljohani,Kholod H,
Y1 - 2026/03/25/
PY - 2026/3/25/accepted
PY - 2026/4/27/medline
PY - 2026/4/27/pubmed
PY - 2026/4/27/entrez
PY - 2026/3/25/pmc-release
KW - adverse transfusion reaction
KW - anemia and hyperbilirubinemia
KW - blood transfusion reaction
KW - urticaria
KW - yellow urticaria
SP - e105814
EP - e105814
JF - Cureus
JO - Cureus
VL - 18
IS - 3
N2 - Yellow urticaria is a rare clinical variant of urticaria characterized by yellowish wheals, typically associated with hyperbilirubinemia. Its occurrence as a transfusion-related reaction is uncommon and may mimic more serious transfusion complications. We report the case of a 15-year-old Saudi female patient who presented with prolonged vaginal bleeding and severe iron deficiency anemia requiring packed red blood cell transfusion. Approximately 15 minutes after transfusion initiation, she developed pruritic yellowish urticarial wheals over the trunk and extremities, without angioedema or hemodynamic instability. Laboratory evaluation revealed mild hyperbilirubinemia, while direct and indirect Coombs tests were negative, and no clinical or laboratory evidence suggestive of hemolysis was identified. The transfusion was temporarily interrupted, and the patient was treated with antihistamines, corticosteroids, and epinephrine, leading to complete resolution of the lesions within 24 hours. Transfusion was later resumed without recurrence. This case highlights transfusion-related yellow urticaria as a benign but rare reaction. Early recognition is essential to avoid misdiagnosis and unnecessary interruption of life-saving transfusion therapy.
SN - 2168-8184
UR - https://www.unboundmedicine.com/prime/citation/42037902/A_Rare_Case_of_Yellow_Urticaria_Developing_During_Blood_Transfusion.
DB - PRIME
DP - Unbound Medicine
ER -
