Post-Transfusion Purpura

Cimo, Philip L.; Aster, Richard H.

doi:10.1056/nejm197208102870608

Cited by 73 publications

(8 citation statements)

References 8 publications

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“…Our patient, treated with massive doses (2 g daily) of intravenous methylprednisolone sodium succinate for the first three days, improved rapidly and the platelet count was normal by five days. Similar therapeutic results were obtained in two cases treated by exchange transfusion (Shulnan et al, 1961;Cimo and Aster, 1972). We therefore consider short courses of highdose corticosteroids worthy of further trial in the treatment of post-transfusion purpura. This rare syndrome should be borne in mind when any patient develops thrombocytopenia after blood or plasma transfusion and must be remembered as another potential hazard of these frequently used materials.…”

Section: Commentsupporting

confidence: 74%

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Post-transfusion purpura associated with unusual platelet antibody (anti-Pl-B1).

Vaughan-Neil¹,

Ardeman²,

Blakeman³

et al. 1975

BMJ

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Section: Commentsupporting

confidence: 74%

“…Almost all patients with this disorder have had pregnancies or have had blood transfusions some years earlier (Shulman az al., 1961;Morrison and Mollison, 1966;Cimo and Aster, 1972). The condition is usually self-limiting though one death from intracranial haemorrhage has been reported (Gockerman and Shulman, 1973).…”

Section: Medical Memorandamentioning

confidence: 99%

Post-transfusion purpura associated with unusual platelet antibody (anti-Pl-B1).

Vaughan-Neil¹,

Ardeman²,

Blakeman³

et al. 1975

BMJ

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“…The first drop in platelet count was recorded 20 to 21 days after transfusions of PRBC and 11 to 21 days after plasma transfusion (Figure 1). Both PRBC and plasma transfusions have been associated with PTP [5]. The diagnosis of PTP in our patient was supported by serologic studies demonstrating an alloantibody directed against HPA-5b and by genotyping indicating that our patient was homozygous for HPA-5a.…”

Section: Discussionsupporting

confidence: 66%

Post-transfusion purpura in an African-American man due to human platelet antigen-5b alloantibody: a case report

et al. 2012

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IntroductionPost-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. It occurs primarily in women sensitized by pregnancy and is most commonly caused by anti-human platelet antigen-1a antibodies. Here, we describe what we believe to be the first documented case of an African-American man who developed post-transfusion purpura due to an anti-human platelet antigen-5b alloantibody after receiving multiple blood products.Case presentationA 68-year-old African-American man initially admitted with atrial flutter was started on anticoagulation treatment, which was complicated by severe hematemesis. On days 4 and 5 of hospitalization, he received six units of packed red blood cells, and on days 4, 13 and 14 he received plasma. His platelet count began to drop on day 25 and on day 32 reached a nadir of 7 × 109/L. His platelet count increased after receiving intravenous immune globulin. An antibody with reactivity to human platelet antigen-5b was detected by a solid-phase enzyme-linked immunoassay. Our patient was homozygous for human platelet antigen-5a.ConclusionThis case emphasizes the importance of including post-transfusion purpura in the differential diagnosis for both men and women with acute onset of thrombocytopenia following transfusion of blood products. The prompt recognition of this entity is crucial for initiation of the appropriate management.

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“…If further studies show that destruction of platelets by autoantibodies in PTP is a general phenomenon, this will provide added justification for use of corticosteroids and agents such as IV IgG and rituximab in patients who experience prolonged thrombocytopenia and/or have intractable bleeding symptoms and will strengthen the rationale for use of plasma exchange transfusion, a treatment shown to be highly effective in some of the early reported cases of PTP [26]. …”

Section: Discussionmentioning

confidence: 99%