Post-transfusion purpura following open heart surgery: management by high dose intravenous immunoglobulin infusion.
We present three cases of post-transfusion purpura (PTP) developing in the immediate post operative period after open heart surgery. All had developed platelet specific antibodies and severe anaphylactoid reactions occurred to platelet transfusion in two cases. Treatment with high dose intravenous immunoglobulin (IV IgG) led to complete recovery in two patients one of whom demonstrated a marked biphasic response pattern to therapy. The other died from congestive cardiac failure. PTP is a potentially fatal complication which may well become more frequent with increasing blood product usage.
Walker
W S
WS
Department of Cardiac Surgery, Edinburgh Royal Infirmary, UK.
Yap
P L
PL
Kilpatrick
D C
DC
Boulton
F E
FE
Crawford
R J
RJ
Sang
C T
CT
D000368:Aged; D001323:Autoantibodies / Q000032:analysis; D001792:Blood Platelets / Q000276:immunology; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D011696:Purpura, Thrombocytopenic / Q000209:etiology / Q000628:therapy*; D065227:Transfusion Reaction
D001323:Autoantibodies; D007074:Immunoglobulin G