A patient with post-transfusion purpura is reported. This female patient, sensitized by previous blood transfusion, developed symptomatic thrombocytopenia seven days after a second blood transfusion. A platelet antibody, which had anti-P1A1 specificity, was identified by 51Cr-release assay and by indirect immunofluorescence. Hemorrhage stopped abruptly after plasma exchange therapy. Thrombocytopenia did not recur when the patient was further challenged with P1A1-positive blood and plasma. Anti-P1A1 antibody, detectable by immunofluorescence but not by complement-dependent platelet cytoxicity, persisted in high titer for at least one year after recovery. The heterogeneity and pathogenesis of this clinical syndrome are discussed.

This study was undertaken to ascertain the incidence, the associated clinical diseases, and the serologic characteristics and significance of positive direct antiglobulin tests (DAT) in a hospital population. Forty-one (0.9%) of 4,664 medical-surgical patients had positive DAT's on admission. Eight of these 41 people also had antibodies in their sera. Twelve patients were taking alpha-methyldopa and one cephalothin, seven had malignant tumors, nine had immunologic disease, and 12 had miscellaneous conditions. Elution of antibodies from the erythrocytes of 36 patients was attempted: 17 eluates failed to react with panel cells; anti-K antibody was found in the eluates from two patients who had recently received transfusions; five eluates showed no blood-group specificity; and 12 agglutinated all panel cells. Eleven of the last 12 eluates, after absorption with Rh-negative cells, were tested with Rh cells of various phenotypes, and weaker or negative results with Rhnull cells were obtained with seven absorbed eluates. Three of the 41 patients had mild to overt hemolysis.

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Four technics were compared to find the most suitable screening test for the cytomegalovirus (CMV) antibody status in blood donors. One hundred thirty-five donor samples were tested by two enzyme immunoassays, EIA(Litton) and EIA(Abbott), and by latex agglutination (LA) and complement fixation (CF). The seroreactivity of the tests were judged by concordance of three or more methods. The authors found that the test performance of the EIA(Litton) could be improved with adjustment of sample color variation, which increased the test sensitivity and specificity from 48.8% and 87.2% to 83.8% and 96.4%, respectively. Both the EIA(Abbott) and LA technics proved to be ideal screening tests with 100% sensitivity and negative predictive values. However, the rapid turnaround time and the simplicity in technics and equipment used with the LA test make it the test of choice for blood donor screening.