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Transfusion medicine

Tranfusion side effects

Post transfusion purpura (PTP)

Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 5 November 2011, last major update September 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.

General
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● Rare complication of transfusion (0.3 out of 100,000 components transfused in the UK)
● Typically occurs 2–14 days after transfusion of pRBC, platelets or plasma, resulting in platelet count < 10,000/mcL
● Most often implicated in transfusion of pRBCs
● Often seen in multiparous women with prior sensitization from pregancies

Pathophysiology
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● Immune thrombocytopenia from antiplatelet alloantibodies (most commonly anti-HPA-1a)
● Occurs in both transfused and autologous platelets; mechanism of destroying autologous platelets is unknown

Clinical manifestation
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● Unexplained bruising or bleeding 2–14 days after transfusion
● Mortality of 10% due to bleeding
● About 30% have major bleeding
● If disease is limited, platelet count will recover within 21 days

Diagnosis
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● Confirmed by detection of platelet-specific alloantibodies
● Differential diagnosis: ITP, drug-induced, DIC/TTP, heparin induced thrombocytopenia (Thromb Res 2000;100:115)

Treatment
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● IV immunoglobulin (0.4 g/kg/day for 5-8 days)
● Possibly plasmapheresis or corticosteroids
● Platelet transfusions usually NOT recommended

Case reports
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● Patient with HPA-1a and GPIa/IIa antibodies (Transfus Med 2006;16:69)

End of Transfusion Medicine > Tranfusion side effects > Post transfusion purpura (PTP)

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