Ptp is defined as post transfusion purpura potentially lethal complication of blood transfusion frequently. A history of recent blood transfusion raised the suspicion of ptp and the diagnosis was confirmed. Alloimmunization to platelet antigens exposes to a serious immunological incident. These alloantibodies destroy the patients platelets leading to thrombocytopenia, a. Posttransfusion purpura ptp is a rare but well defined syndrome first characterized by shulman et al. What is the abbreviation for posttransfusion purpura.
Ptp is a rare delayed transfusion reaction where a patient develops dramatic, sudden and selflimiting thrombocytopenia platelet counts transfusion. However, allogenic blood cells and plasma proteins are foreign substances that can elicit an immune response in transfusion recipients, and plasma contains antibodies and other immune mediators that can react with recipient cells. Ptp stands for post transfusion purpura potentially lethal complication of blood transfusion. Post transfusion purpura ptp is a rare but well defined syndrome first characterized by shulman et al. We report a probable case of a posttransfusion purpura from homozygous sickle cell child alloimmunized against platelet antigen. Dec 12, 2012 post 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.
To receive access to the full text of freely available articles, alerts, and more. Diagnosis and management of posttransfusion purpura case. Blood transfusion is one of the most common procedures in patients in hospital so it is imperative that clinicians are knowledgeable about appropriate blood product administration, as well as the signs, symptoms, and management of transfusion reactions. An extremely rare transfusion reaction only 250 cases reported. Nov 15, 20 hpa genotyping and hpa antibody identification by maipa were performed to investigate post transfusion purpura, which showed. Ivig 400 mgkg was infused in two consecutive days, with normal platelet counts observed after a week. We detail the challenges of alloantibody identification and transfusion management. Formation of alloantibodies against h p a l a is observed during pregnancy and may result in neonatal alloimmune thrombocytopenia naitp or posttransfusion purpura 4, 5. These antibodies cause destruction of the transfused platelets as well. National users board sanquin blood supply organisation. How is post transfusion purpura potentially lethal complication of blood transfusion abbreviated. Hpa1bb, 3aa, 5aa and 15ab and presence of antibodies antihpa1a.
Posttransfusion purpura in a woman with acute myeloid. A coagulopathy b hypercalcemia c hyperkalemia d hypothermia. Prior exposure to foreign platelet antigens, through transfusion, transplant or pregnancy can result in antihuman platelet antigen antibodies. Posttransfusion immunologic purpuraa newly recognized.
Its incidence is approximately 1 in 50 000100 000 blood transfusions and occurs more commonly in. Posttransfusion purpura ptp is an acute episode of severe immune thrombocytopenia occurring about a week after transfusion. Pdf posttransfusion purpura is a rare transfusionrelated complication that often goes undiagnosed. Two patients with posttransfusion thrombocytopenic purpura are described, the first cases recognized in austria and germany.
May 23, 20 posttransfusion purpura ptp is an uncommon, but potentially fatal, transfusion reaction characterized by profound thrombocytopenia and bleeding. Thirteen cases of posttransfusion purpura ptp which were diagnosed in germany. It occurs primarily in women sensitized by pregnancy and is most commonly caused by antihuman platelet antigen1a antibodies. Thrombotic thrombocytopenia ttp is a life threatening disorder characterized by clotting in small blood vessels resulting in reduced blood supply to end organs such as the central nervous system and kidneys and is associated with thrombocytopenia and microangiopathic haemolytic anaemia. Posttransfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet transfusion that occurs when the body has produced alloantibodies to the allogeneic transfused platelets antigens. Post transfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Ptp is caused by alloimmunization to human platelet specific antigens following blood component transfusion. Posttransfusion purpura ptp, first described in the late 1950s, 2,151,152 is a rare but serious complication of blood transfusion. Two patients with post transfusion thrombocytopenic purpura are described, the first cases recognized in austria and germany. Which of the following is not a delayed complication of blood transfusion. Cbo mandating organisations netherlands general practitioners association nhg netherlands internists association netherlands orthopaedic association netherlands association of anaesthesiology employees. A rare but serious hemorrhagic complication following blood transfusion, which heretofore had been indistinguishable from idiopathic thrombocytopenic purpura, was elucidated by finding in two patients who developed fulminant purpura one week post transfusion, a hightiter antibody which reacted with platelets to cause complement fixation, agglutination, and inhibition of clot retraction. A leucine 3 to proline 3 substitution in gpiiia is the basis of this polymorphism 3.
You will be directed to to complete your registration. Three new patients with post transfusion purpura ptp are described. Posttransfusion purpura case archetype previous exposure to blood through pregnancy or transfusion develops severe thrombocytopenia days to weeks post transfusion of cellular product is totally refractory to platelet transfusions possibly with mixed febrile allergic reactions to platelets positive platelet. Diagnosis and management of posttransfusion purpura. Posttransfusion 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. A rare but serious hemorrhagic complication following blood transfusion, which heretofore had been indistinguishable from idiopathic thrombocytopenic purpura, was elucidated by finding in two patients who developed fulminant purpura one week posttransfusion, a hightiter antibody which reacted with platelets to cause complement fixation, agglutination, and inhibition of clot retraction. Although this is rare and less common in males, it can occur, particularly as a patients comorbidities increased. Which of the following is not a complication of massive blood transfusions. Transfusion observations, adverse reactions and care of the patient karen mead. In one case, thrombocytopenia was associated with agranulocytosis due to. The thrombocytopenic episode lasted for 22 and over 60 days. Posttransfusion purpura ptp is a rare complication of blood transfusion characterized by the precipitous onset of severe thrombocytopenia and absolute. The purpura was evoked by blood transfusions with a latent period of 2 and 7 days.
Post transfusion purpura transfusion associated graftversushost disease. Posttransfusion purpura ucsf internal medicine chief. Transfusion of cellular blood products containing any platelets e. Prednisone therapy of posttransfusion purpura annals of. May 24, 20 posttransfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Posttransfusion purpura successful treatment by exchange. Prior exposure to foreign platelet antigens, through transfusion, transplant or pregnancy. Transfusion purpura, british journal of haematology 10. Post transfusion purpura template version 0104 authors. Posttransfusion purpura in an africanamerican man due to.
Logdberg, in blood banking and transfusion medicine second edition, 2007. Post 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. Nov 09, 2019 post transfusion purpura post transfusion purpura is a relatively uncommon complication of blood transfusion pathophysiology. It is a delayed transfusion reaction involving platelets, where the recipient of a blood transfusion forms antibodies against human platelet antigen 1a hpa1a. As the manifestations in two differ significantly from those of previously reported cases, they serve to expand the definition of this syndrome. The spots are caused by bleeding underneath the skin secondary to platelet disorders, vascular disorders, coagulation disorders, or other causes. Patients transfused rbc pre hospital march 2015 august 2018 trauma patients who received rbc and ffp pre hospital in. Post transfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by. Post transfusion purpura ptp can occur in patients who have been previously sensitized to platelets by transfusion or through pregnancy.
Posttransfusion purpura ptp can occur in patients who have been previously sensitized to platelets by transfusion or through pregnancy. Post transfusion purpura ptp workup bloodworks northwest. Posttransfusion purpura ptp is an uncommon, but potentially fatal, transfusion reaction characterized by profound thrombocytopenia and bleeding. Transfusion associated circulatory overload febrile nonhaemolytic transfusion reactions allergic reactions delayed transfusion reactions 24 hours delayed haemolytic transfusion reaction alloimmunisation transfusion associated ta graftversushost disease gvhd post transfusion purpura transfusion transmitted. Posttransfusion purpura is an immune mediated transfusion reaction with a low incidence in transfusion recipients.
Posttransfusion purpura definition of posttransfusion. Three new patients with posttransfusion purpura ptp are described. A trali b tgvh c post transfusion purpura d iron overload 36. Posttransfusion purpura an overview sciencedirect topics. Here, we report a case of posttransfusion purpura in a 56yearold multiparous woman who. Post transfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet transfusion that occurs when the body has produced alloantibodies to the allogeneic transfused platelets antigens. It can be thought of a delayed transfusion reaction involving platelets here there is an immunological response to a previously encountered foreign platelet that leads to an increase in the production of antiplatelet. Transfusions can be lifesaving for patients with severe anemia, thrombocytopenia, or deficiency of plasma components. Its incidence is approximately 1 in 50 000100 000 blood transfusions and occurs more commonly in multiparous women. Posttransfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by. Transfusion purpura, british journal of haematology. Posttransfusion purpura ptp pdf national blood authority. Posttransfusion purpura in an africanamerican man due to human.
Posttransfusion purpura occurs when a person with an antiplatelet antibody is transfused with platelets expressing the corresponding antigen. These alloantibodies destroy the patients platelets leading to thrombocytopenia, a rapid decline in platelet count. We report a probable case of a post transfusion purpura from homozygous sickle cell child alloimmunized against platelet antigen. Posttransfusion purpura post transfusion purpura is a relatively uncommon complication of blood transfusion pathophysiology. Although there is evidence of a wide serological spectrum of culprit antibodies implicated, antihumanplateletantigen hpa 1a is the. Posttransfusion purpura transfusionassociated graftversushost disease. Posttransfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Posttransfusion purpura is a rare immunohematological disorder characterized by severe thrombocytopenia following transfusion of blood. Posttransfusion purpura ptp australian red cross lifeblood.
Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions post transfusion purpura ptp level of. Blood transfusion clinical guideline michigan medicine. Thrombocytopenia nat, posttransfusion purpura ptp and platelet transfusion refractoriness are associated with the development of plateletspecific antibodies. Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions level of.
A posttransfusion platelet count should be obtained 10 minutes to 1 hour after transfusion for best assessment of transfusion effectiveness. Posttransfusion purpura ptp is a rare, yet potentially fatal bleeding disorder characterized by severe. Although all 14 previously reported cases have occurred in pl a1negative females, one of our patients was a planegative male. Posttransfusion purpura article about posttransfusion. Posttransfusion purpura is a complication of blood product transfusion in which the recipient produces antiplatelet antibodies resulting in severe thrombocytopenia. Posttransfusion purpura thrombocytopenia blood transfusion platelet antibodies hla antigens. Although recurrence is rare, precautions should be taken if patients with a history of ptp require transfusions in the future. Specialist working group for haematology proposed changes to the criteria for the clinical use of intravenous immunoglobulin in australia, second edition. Diagnosis and management of post transfusion purpura. It occurs after transfusion of any plateletcontaining product red blood cells or platelets causing acute profound thrombocytopenia 1. It is characterized by the sudden onset of thrombocytopenia with purpura in the 710 days following a blood transfusion. Pdf posttransfusion purpura is a rare syndrome characterized by severe thrombocytopenia and.
Pdf jaleah hawkins,1 richard h aster,2,3 brian r curtis2,3 1versiti, blood center of michigan, grand rapids, mi, usa. Pathophysiology, treatment, and prevention of posttransfusion purpura ptp ptp is caused by plateletspecific antibodies in a patient who has been previously exposed to platelet antigens through pregnancy or transfusion. Hpa genotyping and hpa antibody identification by maipa were performed to investigate posttransfusion purpura, which showed. Transfusion medicine a nonimmune response to transfusion of packed rbcs and ffp, attributed to passive transfer of antibodies from donor plasma, resulting in complement activation and lung injury clinical bilateral pulmonary edema, hypoxia, tachycardia, fever and hypotension occurring within 6 hrs of transfusion. Bleeding from mucous membranes and the gastrointestinal and urinary tracts is common. Ptp abbreviation stands for posttransfusion purpura. The present report describes an additional patient, a multiparous female who developed petechiae 7 days after blood transfusion. Pathophysiology, treatment, and prevention of post. Post transfusion purpura is a complication of blood product transfusion in which the recipient produces antiplatelet antibodies resulting in severe thrombocytopenia.
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