eli5: Why does donating blood risk triggering an existing autoimmune disorder?

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This is not a false premise, I am not eligible to donate blood for this reason.

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Anonymous 0 Comments

While I’m resident physician specializing in emergency medicine and not rheumatology, to my knowledge there’s several possible reasons.

There is a [list of medications](https://www.redcrossblood.org/donate-blood/manage-my-donations/rapidpass/medication-deferral-list.html) that include some treatments for auto-immune diseases, and I know of several off the top of my head not listed (Methotrexate, Hydroxychloroquine) that are commonly used in auto-immune diseases like RA/Lupus, that are toxic and not appropriate for blood transfusion. This could be a reason to exclude you.

Often people with auto-immune diseases are prone to infection, both because of their condition and the medicines they take for it. So any needle puncture is a chance for infection. When doing preventative medicine labwork or IV access during hospitalization, the risk and benefit is weighed and the benefit of having IV access (particularly in the hospital) usually outweighs the risk. But in blood donation, a pint of blood is not worth risking sepsis.

People with auto-immune diseases are also often anemic, which excludes from blood donation. My experience has been that this is tested on every donor, but perhaps some donation sites see it as a cost-saving measure. By excluding people with chronic anemia, they save the cost of testing. This is hypothetical, I don’t know if this is true.

As far as I’m aware, receiving blood from someone with an auto-immune disease such as rheumatoid arthritis, lupus, etc does not pose any greater risk to the recipient so long as they’re not on potentially harmful disease-modifying therapies. I could maybe see the hypothetical, but I’d be far more interested in reading applicable literature.

[Here’s an appropriate NIH article](https://www.ncbi.nlm.nih.gov/books/NBK138205/) worth looking over if you’re interested. It’s not ELI5 level, but it’s also not inaccessible.

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