A second case of post-transfusion purpura caused by HPA-5a antibodies: successful treatment with intravenous immunoglobulin.
Post-transfusion purpura (PTP) is a rare disorder characterized by severe thrombocytopenia developing seven to 10 days following transfusion of platelet-containing blood components, in a person who was previously sensitized via transfusion or pregnancy. Although most cases of PTP are caused by alloantibodies directed against HPA-1a[(Pl(A1))], this case represents the second example of anti-HPA-5a-associated PTP. A 61-year-old female was diagnosed with acute myocardial infarction and gastrointestinal bleeding and, after receiving six units of packed red cells over 5 days, developed PTP as a result of HPA-5a [Br(b)] antibodies with severe thrombocytopenia (5000/microl). She was successfully treated with intravenous immunoglobulin (IVIG), suggesting that this is a highly effective mode of treatment for PTP, regardless of the antibody implicated.
Department of Transfusion Medicine, Cedars-Sinai Medical Center, B700 Beverly Boulevard, Los Angeles, CA, USA.
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Ziman
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Klapper
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Pepkowitz
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Smith
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Garratty
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Goldfinger
D016824:Antigens, Human Platelet / Q000276:immunology*; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007518:Isoantibodies / Q000009:adverse effects* / Q000097:blood; D008875:Middle Aged; D011696:Purpura, Thrombocytopenic / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D016896:Treatment Outcome
C071092:5a alloantigen, human; D016824:Antigens, Human Platelet; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies