Here, we report a case of posttransfusion purpura in a 56. Posttransfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet. You may reuse this information excluding logos free of charge in any format or medium, under the terms of. May 23, 20 posttransfusion purpura ptp is an uncommon, but potentially fatal, transfusion reaction characterized by profound thrombocytopenia and bleeding. Posttransfusion purpura is quite rare, and is characterized by acute, usually severe, thrombocytopenia 7 to 10 days after a blood transfusion. Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions level of. These antibodies cause destruction of the transfused platelets as well. Post transfusion purpura is an acute episode of severe thrombocytopenia occurring 58 days after blood transfusion in a patient with a history of sensitization by pregnancy or transfusion. Pathophysiology, treatment, and prevention of post transfusion purpura ptp ptp is caused by plateletspecific antibodies in a patient who has been previously exposed to platelet antigens through pregnancy or transfusion. Ptp typically occurs 214 days after transfusion, most commonly after rbc product, resulting in acute, profound thrombocytopenia platelet count transfusion reaction where a patient develops dramatic, sudden and selflimiting thrombocytopenia platelet counts transfusion. Posttransfusion purpura is a complication of blood product transfusion in which the recipient produces antiplatelet antibodies resulting in severe thrombocytopenia. Diagnosis and management of post transfusion purpura. Post transfusion purpura ptp can occur in patients who have been previously sensitized to platelets by transfusion or through pregnancy.
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. What is the abbreviation for posttransfusion purpura. Posttransfusion purpura in an africanamerican man due to. Prior exposure to foreign platelet antigens, through transfusion, transplant or pregnancy can result in antihuman platelet antigen antibodies. Transfusion of cellular blood products containing any platelets e. Patients transfused rbc pre hospital march 2015 august 2018 trauma patients who received rbc and ffp pre hospital in. Management of immune thrombocytopenic purpura in adults from the department of medical sciences, regina apostolorum hospital, albano laziale, italy r. Posttransfusion purpura ptp is a rare complication of transfusion that most commonly occurs in previously pregnant women. Specialist working group for haematology proposed changes to the criteria for the clinical use of intravenous immunoglobulin in australia, second edition. The antibody against the human platelet alloantigen hpa1a. Blood transfusion clinical guideline michigan medicine. Post transfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by. View the article pdf and any associated supplements and figures for a period of 48 hours.
An overview 1 isbt human blood group systems number name abbreviation 001 abo abo 002 mnss mnss 003 p p 004 rh rh 005 lutheran lu 006 kell kel 00 7 lewis le abo ag secretories 008 duffy fy. Posttransfusion purpura ptp australian red cross lifeblood. The pdf version is identical to the hard copy of the book. Posttransfusion purpura article about posttransfusion. Logdberg, in blood banking and transfusion medicine second edition, 2007. Calendar year cy 2018 clinical laboratory fee schedule.
Passive transfer of platelet antibodies is a separate entity from ptp with different. It is due to alloimmunization against platelet antigens which leads to acute profound thrombocytopenia following the transfusion of any plateletcontaining product red blood cells or platelets. Post transfusion purpura is an acute, severe, thrombocytopenic state that has been described in 15 patients. Post transfusion purpura is a complication of blood product transfusion in which the recipient produces antiplatelet antibodies resulting in severe thrombocytopenia. Post transfusion purpura ptp is an uncommonly reported post transfusion adverse event that can present with severe thrombocytopenia. Posttransfusion definition of posttransfusion by medical. Transfusion support of thrombotic thrombocytopenic purpura ttp. Posttransfusion purpura ucsf internal medicine chief.
Posttransfusion purpura is an immune mediated transfusion reaction with a low incidence in transfusion recipients. The washington manual of medical therapeutics spiral manual series, lippincott williams. George department of medicine, college of medicine, department of biostatistics and epidemiology, college of public health. Free igg in plasma inhibits the binding of igg red cell antibodies to fc. Post transfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by alloimunization to human platelet specific antigens following a blood component transfusion. Posttransfusion purpura definition of posttransfusion. Post transfusion purpura is a topic covered in the washington manual of medical therapeutics to view the entire topic, please sign in or purchase a subscription the washington manual of medical therapeutics helps you diagnose and treat hundreds of medical conditions. Although this is rare and less common in males, it can occur, particularly as a patients comorbidities increased.
Platelet transfusion and thrombotic thrombocytopenic purpura. Thrombocytopenia occurs approximately one week after the administration of blood,1, 2 a. 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. Clinical guide to transfusion professional education. A case of posttransfusion purpura was notable for the manner of antibody detection and response to therapy. The most frequently identified antibody is antipla1. Posttransfusion definition of posttransfusion by merriam.
Post transfusion purpura ptp is a rare bleeding disorder of platelet alloimmunization that perhaps occurs as an anamnestic reaction. This guide is an educational resource for health care workers on the provision of blood products and transfusion medicine services in canada. Three new patients with posttransfusion purpura ptp are described. Posttransfusion purpura ptp pdf posttransfusion purpura ptp pdf file. Free from infections that could be harmful to the recipient. Cushing md, in transfusion medicine and hemostasis second edition, 20. Transfusion medicine posttransfusion purpura ptp assessment. The recipients always have a history of sensitization. Pdf posttransfusion purpura is a rare transfusionrelated complication that often goes undiagnosed. Pdf posttransfusion purpura is a rare syndrome characterized by severe thrombocytopenia and. Send out testing identified the patient has both hla class i antibodies and is homozygous for hpa1b platelet antigen, with an antibody to hpa1a. Immunological complications of blood transfusion medscape. Definition, diagnosis and treatment of immune thrombocytopenic purpura james n. 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. Pathophysiology, treatment, and prevention of post. The page below is a sample from the labce course transfusion reactions. No platelet increment was achieved despite transfusions with buffy coat, hlacompatible, and hpa1a negative platelets. Post transfusion purpura ptp is a rare bleeding disorder caused by alloantibodies specific to platelet antigens. Transfusion support of thrombotic thrombocytopenic purpura ttp nicholas bandarenko, md, fcap director, transfusion services duke university.
It is fully printable and may be used to make slides, handouts etc. The typical patient is a multiparous woman who develops sudden severe purpura 1 week after receiving a transfusion of packed red cells or whole blood. Hpa1bb, 3aa, 5aa and 15ab and presence of antibodies antihpa1a. Its incidence is approximately 1 in 50 000100 000 blood transfusions and occurs more commonly in multiparous women. Ptp is characterized by the development of severe, sudden and selflimiting thrombocytopenia occurring 510 days after a blood transfusion. An extremely rare transfusion reaction only 250 cases reported.
As the manifestations in two differ significantly from those of previously reported cases, they serve to expand the definition of this syndrome. 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. Most commonly, it is observed in pla1negative subjects previously sensitized with pla1 platelet antigen either through pla1positive pregnancy or pla1positive transfusion. 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.
We detail the challenges of alloantibody identification and transfusion management. Transfusions can be lifesaving for patients with severe anemia, thrombocytopenia, or deficiency of plasma components. Its diagnosis can be elusive given its substantial symptomatic overlap with other thrombocytopenic syndromes. 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. Odum, do resident physician university of missouricolumbia department of pathology and anatomical sciences. Ptp is caused by alloimmunization to human platelet specific antigens following blood component transfusion. Ptp typically occurs 214 days after transfusion, most commonly after rbc product, resulting in acute, profound thrombocytopenia platelet count posttransfusion purpura, which showed.
As a result, transfusion carries risks of immunologic reactions. A posttransfusion platelet count should be obtained 10 minutes to 1 hour after transfusion for best assessment of transfusion effectiveness. Post transfusion purpura template version 0104 authors. Ptp abbreviation stands for posttransfusion purpura. Transfusion purpura, british journal of haematology.
Posttransfusion purpura occurs when a person with an antiplatelet antibody is transfused with platelets expressing the corresponding antigen. American society for apheresis asfa therapeutic apheresis waldenstrom s macroglobulinemia cryoglobulinemia post transfusion purpura a. Jun 01, 2003 read platelet transfusion and thrombotic thrombocytopenic purpura, transfusion on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Posttransfusion purpura washington manual of medical. Posttransfusion purpura is a rare transfusion related complication that often goes undiagnosed.
Some of these cookies are essential to the operation of the site, while others help to improve your experience by providing insights into how the site is being used. The typical patient is a multiparous woman who develops sudden severe purpura 1 week after receiving a transfusion. Apr 28, 2017 posttransfusion purpura ptp what is it. Adverse effects of transfusion moffitt cancer center. Although all 14 previously reported cases have occurred in pl a1negative females, one of our patients was a planegative male. Although the frequency and extent of rbc and platelet transfusions are increased during the posttransplantation period, the indications for these transfusions do. Posttransfusion purpura ptp, first described in the late 1950s, 2,151,152 is a rare but serious complication of blood transfusion. The antibody failed to fix complement but was detected by platelet aggregometry studies and confirmed by the chromium 51 release assay.
Alloimmunization to platelet antigens exposes to a serious immunological incident. Posttransfusion purpura an overview sciencedirect topics. 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. It is a delayed transfusion reaction involving platelets, where the recipient of a blood transfusion forms antibodies against human platelet antigen 1a hpa1a. Release of free hgb and hgb free rbc stroma into circulation b stimulation of intrinsic coag pathway and bradykinin via agab complexes.
Pdf version identical to the printed book right click this link and select save target as. A young female was diagnosed with acute leukaemia, and treatment commenced. Online prepublication allows accepted articles to be visible and indexed about 6 months earlier than the print publication date. The bci describes the blood components produced by australian red cross lifeblood, including a description of the blood collection process, method of manufacture, critical manufacturing steps, clinical indications for use, and administration methods. Posttransfusion purpura is a rare transfusionrelated complication that. Posttransfusion purpura successful treatment by exchange. Sergio torloni md a free powerpoint ppt presentation displayed as a flash slide show on id. Clinical transfusion practice world health organization.
A case of posttransfusion purpura with severe refractory. It occurs primarily in women sensitized by pregnancy and is most commonly caused by antihuman platelet antigen1a antibodies. Posttransfusion purpura ptp is a rare, yet potentially fatal bleeding disorder characterized by severe thrombocytopenia, purpura. Home posttransfusion purpura ptp pdf posttransfusion purpura ptp pdf file. Post transfusion purpura ptp is a rare but well defined syndrome first characterized by shulman et al. As soon as a paper is accepted, edited and corrected, it is posted online in its definitive version. Ptp is a rare delayed transfusion reaction where a patient develops dramatic, sudden and selflimiting thrombocytopenia platelet counts transfusion. Complications of massive blood transfusion ketan vagholkar. Post transfusion purpura ptp workup bloodworks northwest. Posttransfusion purpura ptp pdf national blood authority. Post transfusion purpura ptp is an uncommonly reported post transfusion adverse.
Odum, do resident physician university of missouri. It is characterized by the sudden onset of thrombocytopenia with purpura in the 710 days following a blood transfusion. Post transfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Inf731 ovarian tissue cryopreservation information for patients. Subscribe to americas largest dictionary and get thousands more. Immunization against this glycoprotein gp should be considered in. With great pleasure we present the new online edition of the canadian blood services clinical guide to transfusion. Pdf jaleah hawkins,1 richard h aster,2,3 brian r curtis2,3 1versiti, blood center of michigan, grand rapids, mi, usa. Jane doe is a 63 year old woman who presented 11 days after prbc transfusion with severe thrombocytopenia, altered mental status and diffuse petechiae. Immunological complications of blood transfusion taylor 2008. Its incidence is approximately 1 in 50 000100 000 blood transfusions and occurs more commonly in. Occurring after or as a consequence of blood transfusion. Transfusion support issues in hematopoietic stem cell.
Post transfusion purpura this test is referred to another lab outside our network this does not affect where samples are sent and where your results are issued. Post transfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet. These challenges are due to the lack of laboratory techniques for typing hla and hpa system and the. Although there is evidence of a wide serological spectrum of culprit antibodies implicated, antihumanplateletantigen hpa 1a is the. Individual reprints of this article are not available. Preoperative anaemia identification, assessment and management case study. Management of immune thrombocytopenic purpura in adults. 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. Learn more about transfusion reactions online ce course. Posttransfusion definition is caused by transfused blood. 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. Bleeding from mucous membranes and the gastrointestinal and urinary tracts is common. Posttransfusion purpura is a serious adverse effect of transfusion due to hpaantibodies. These alloantibodies destroy the patients platelets leading to thrombocytopenia, a.