Ptp typically occurs 214 days after transfusion, most commonly after rbc product, resulting in acute, profound thrombocytopenia platelet count pdf available. Posttransfusion purpura ptp is a rare and delayed transfusion reaction that typically occurs in multiparous women. Post transfusion purpura ptp is a rare bleeding disorder of platelet alloimmunization that perhaps occurs as an anamnestic reaction. Ptp appears with sudden severe thrombocytopenia, purpura, and often lifethreatening. Posttransfusion purpura should, however, be considered in any patient with thrombocytopenia following infusion of a blood product. Post transfusion purpura template version 0104 authors. Bleeding of variable severity is often present and can be lifethreatening. Highdose igg for post transfusion purpura revisited. Post transfusion purpura investigation canadian blood services. Post transfusion purpura ptp is an uncommonly reported post transfusion adverse event that can present with severe. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10. No platelet increment was achieved despite transfusions with buffy coat, hlacompatible, and hpa1a negative platelets. Some of these cookies are essential to the operation of the site, while others help to improve your experience by providing insights into how the site is being used. Thirteen cases of posttransfusion purpura ptp which were diagnosed in germany and austria from 19771985 are described.
Ptp is a rare delayed transfusion reaction where a. Highdose intravenous immunoglobulin for post transfusion purpura. It occurs primarily in women sensitized by pregnancy and is most commonly caused by antihuman platelet antigen1a antibodies. Prior exposure to foreign platelet antigens, through transfusion, transplant or pregnancy can result in antihuman platelet antigen antibodies. Posttransfusion purpura in an africanamerican man due to. Rbc destruction may be intravascular or extravascular. The typical patient is a multiparous woman who develops sudden severe purpura 1 week after receiving a transfusion of packed red cells or whole blood. Three new patients with post transfusion purpura ptp are described.
Post transfusion purpura ptp submitted by admin on wed, 20100310 12. Posttransfusion purpura ptp is a rare disorder with a historical incidence estimated to be between 1 in 25,000 to 100,000 transfusions. It is characterized by the sudden onset of thrombocytopenia with purpura in the 710 days following a blood transfusion. These alloantibodies destroy the patients platelets leading to thrombocytopenia, a rapid decline in platelet count. Its diagnosis can be elusive given its substantial symptomatic overlap with other thrombocytopenic syndromes. Posttransfusion purpura definition of posttransfusion. A case of posttransfusion purpura with severe refractory. Pathophysiology, treatment, and prevention of post. A young female was diagnosed with acute leukaemia, and treatment commenced. Diagnosis and management of posttransfusion purpura.
Its incidence is approximately 1 in 50 000100 000 blood transfusions and occurs more commonly in multiparous women. Post transfusion purpura is an acute episode of immune thrombocytopenia that follows the administration of certain blood products by seven to ten days. Immune thrombocytopenia purpura itp, also known as idiopathic thrombocytopenic purpura, is a type of thrombocytopenic purpura defined as an isolated low platelet count with a normal bone marrow in the absence of other causes of low platelets. Posttransfusion purpura ptp australian red cross lifeblood. Pdf posttransfusion purpura is a rare transfusionrelated complication that often goes undiagnosed. Pdf posttransfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by alloimunization to. Jane doe is a 63 year old woman who presented 11 days after prbc transfusion with severe thrombocytopenia, altered mental status and diffuse petechiae.
As the manifestations in two differ significantly from those of previously reported cases, they serve to expand the definition of this syndrome. Clerical errors both in transfusion service and at bedside are most common cause c. Posttransfusion immunologic purpuraa newly recognized. Cushing md, in transfusion medicine and hemostasis second edition, 20. It is due to alloimmunization against platelet antigens which leads to acute profound thrombocytopenia following the transfusion of any plateletcontaining product red blood cells or platelets. Complications of transfusion msd manual professional edition.
The british journal of haematology publishes original research papers in clinical, laboratory and experimental haematology. Although all 14 previously reported cases have occurred in pl a1negative females, one of our patients was a planegative male. Highdose intravenous immunoglobulin for posttransfusion purpura. Although this is rare and less common in males, it can occur, particularly as a patients comorbidities increased. Post transfusion purpura is a rare immunohematological disorder characterized by severe thrombocytopenia following transfusion of blood components and induced by an alloantibody against a donor platelet antigen. May 24, 20 posttransfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Transfusion medicine a nonimmune response to transfusion of packed rbcs and ffp, attributed to passive transfer of antibodies from donor plasma, resulting in complement activation and lung injury clinical bilateral pulmonary edema, hypoxia, tachycardia, fever and hypotension occurring within 6 hrs of transfusion. Most commonly, it is observed in pla1negative subjects previously sensitized with pla1 platelet antigen either through pla1positive pregnancy or pla1positive transfusion. Post transfusion purpura ptp is an uncommon but serious transfusion associated complication characterized by profound thrombocytopenia. Post transfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Posttransfusion purpura is a serious adverse effect of transfusion due to hpaantibodies. Posttransfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by alloimunization to human platelet specific antigens following a blood component transfusion. Transfusionassociated circulatory overload taco premedicated delayed febrile delayed hemolytic dhtr transfusionassociated graft vs.
All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of ptp. Post transfusion purpura ptp is an uncommonly reported post transfusion adverse event that can present with severe thrombocytopenia. Posttransfusion purpura ptp is a rare complication of transfusion that most commonly occurs in previously pregnant women. It is caused by alloimmunization against platelet antigens, antihpa1a being the most frequent antibody. Send out testing identified the patient has both hla class i antibodies and is homozygous for hpa1b platelet antigen, with an antibody to hpa1a.
Pathophysiology, treatment, and prevention of post transfusion purpura ptp ptp is caused by plateletspecific antibodies in a patient who has been previously exposed to platelet antigens through pregnancy or transfusion. Post transfusion purpura is a rare transfusion related complication that often goes undiagnosed. Antihpa1a antibody is most commonly associated with this reaction, however other hpa antibody specificities have also been found. Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions post transfusion purpura ptp level of evidence small case studies only. Post transfusion purpura is a complication of blood product transfusion in which the recipient produces antiplatelet antibodies resulting in severe thrombocytopenia. The most frequently identified antibody is antipla1, which reacts with platelet antigen hpa1a. A rare but serious hemorrhagic complication following blood transfusion, which heretofore had been indistinguishable from idiopathic thrombocytopenic purpura, was elucidated by finding in two patients who developed fulminant purpura one week post transfusion, a hightiter antibody which reacted with platelets to cause complement fixation, agglutination, and inhibition of clot retraction. Ptp typically occurs 214 days after transfusion, most commonly after rbc product, resulting in acute, profound thrombocytopenia platelet count post transfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Test description post transfusion purpura ptp is a rare delayed transfusion reaction where a patient develops a sudden and dramatic drop in their platelet count typically between 610 days following red blood cell transfusion. Post transfusion purpura is a very rare complication in which the platelet count falls rapidly 4 to 14 days after an rbc transfusion, causing moderate to severe thrombocytopenia. Posttransfusion purpura ptp, first described in the late 1950s, 2,151,152 is a rare but serious complication of blood transfusion.
Here, we report a case of post transfusion purpura in a 56. Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions level of evidence small case studies only. Host disease tagvhd delayed afebrile posttransfusion purpura ptp iron overload transfusion reactions. Post transfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet transfusion that occurs when the body has produced alloantibodies to the allogeneic transfused platelets antigens.