Post-transfusion purpura: a survey of 12 Danish cases with special reference to immunoglobulin G subclasses of the platelet antibodies.
The clinical and immunological data of 12 Danish cases of post-transfusion purpura (PTP) are summarized. All patients but one were women. All except one had thrombocytopenic purpura which occurred 4-11 days after transfusion, usually with a nadir of the platelet count below 10 x 10(9) 1(-1). The typical haemorrhagic symptoms were cutaneous bleedings, melena and haematuria lasting from 3 to 12 days. The time until normalization of platelet count varied from 3 to 50 days after onset. One patient had recurrence of PTP and one patient died due to intracranial haemorrhage. Ten of the HPA-1a negative patients (83%) had platelet-specific HPA-1a antibodies and two HPA-1a positive individuals had anti-HPA-1b antibodies. In 10 patients, HLA antibodies were also detectable and in one patient a delayed haemolytic transfusion reaction due to anti-E was seen. All of seven patients investigated had anti-HPA antibodies of both IgG1 and IgG3 subclasses during the thrombocytopenic period while all of 10 patients had anti-HPA of only the IgG1 subclass after recovery from PTP. Thus, the destruction of autologous platelets in PTP seems to be associated with the presence of anti-HPA of the IgG3 subclass which may be of importance in the pathogenesis of PTP.
Taaning
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E
Department of Clinical Immunology, Glostrup Hospital, University of Copenhagen, Denmark.
Svejgaard
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000918:Antibody Specificity; D016824:Antigens, Human Platelet / Q000032:analysis / Q000276:immunology*; D001327:Autoimmune Diseases / Q000209:etiology* / Q000276:immunology; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000401:mortality; D003718:Denmark; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000145:classification / Q000276:immunology*; D039661:Integrin beta3; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010298:Parity; D011183:Postoperative Complications; D011696:Purpura, Thrombocytopenic / Q000150:complications / Q000209:etiology* / Q000276:immunology; D012008:Recurrence; D012307:Risk Factors; D065227:Transfusion Reaction
D016824:Antigens, Human Platelet; D006680:HLA Antigens; C061248:ITGB3 protein, human; D007074:Immunoglobulin G; D039661:Integrin beta3; D007518:Isoantibodies