Transfusion medicine
Transfusion side effects
Post transfusion purpura (PTP)

Topic Completed: 1 September 2011

Revised: 5 April 2019

Copyright: 2002-2017,, Inc.

PubMed Search: Posttransfusion purpura [title]

Huy Phu Pham, M.D., M.P.H.
Page views in 2018: 401
Page views in 2019 to date: 313
Cite this page: Pham H. Post transfusion purpura (PTP). website. Accessed June 19th, 2019.
Definition / general
  • Rare complication of transfusion (0.3 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
  • 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
  • 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
  • Confirmed by detection of platelet specific alloantibodies
  • Differential diagnosis: ITP, drug induced, DIC / TTP, heparin induced thrombocytopenia (Thromb Res 2000;100:115)
Case reports
  • IV immunoglobulin (0.4 g/kg/day for 5 - 8 days)
  • Possibly plasmapheresis or corticosteroids
  • Platelet transfusions usually NOT recommended
Back to top