Post-transfusion purpura

Post-transfusion purpura (PTP) is an adverse reaction to a blood transfusion or platelet transfusion that occurs when the body produces alloantibodies to the introduced platelets' antigens. These alloantibodies destroy the patient's platelets leading to thrombocytopenia, a rapid decline in platelet count.[1] PTP usually presents 5–12 days after transfusion, and is a potentially fatal condition.

Mechanism and treatment

PTP is rare, but usually occurs in women who have had multiple pregnancies or in men who have undergone previous transfusions. The precise mechanism leading to PTP is unknown, but it most commonly occurs in individuals whose platelets lack the HPA-1a antigen (old name: PLA1) are transfused platelets that do contain the HPA-1a antigen. The patient develops antibodies to the HPA-1a antigen leading to platelet destruction. It is unclear why alloantibodies attack the patient's own, as well as the introduced platelets.[2] It is usually self-limiting, but IV IgG therapy is the primary treatment.[3] Plasmapheresis is also an option for treatment.[4]

See also

References

  1. ^ Washington University School of Medicine; Cooper, Daniel E.; J Krainik, Andrew; J Lubner, Sam; EL Reno, Hilary, The The Washington Manual of Medical Therapeutics (Spiral Manual Series), Lippincott Williams Wilkins, p. 519, ISBN 978-0-7817-8125-1 
  2. ^ Gresele, Paolo; Page, Clive P.; Fuster, Valentin; Vermylen, Jos (2002), Platelets in Thrombotic and Non-thrombotic Disorders: Pathophysiology, Pharmacology and Therapeutics (1st ed.), Cambridge University Press, p. 551, ISBN 052180261X 
  3. ^ Hillyer, Christopher D.; Hillyer, Krista; Strobl, Frank; Jefferies, Leigh C.; Silberstein, Leslie E. (2001), Handbook of Transfusion Medicine (1st ed.), Academic Press, p. 328, ISBN 0123487757 
  4. ^ Hoffbrand, A. V.; P.A.H. Moss, J.E. Pettit (2006). Essential Haematology: 5th Edition. Blackwell Publishing. ISBN 1-4051-3649-9.