The presence of free hemoglobin in the blood plasma. In patients with acute thrombotic thrombocytopenic purpura ttp or adult. These alloantibodies destroy the patients platelets leading to thrombocytopenia, a rapid decline in platelet count. Posttransfusion immunologic purpuraa newly recognized. Prior exposure to foreign platelet antigens, through transfusion, transplant or pregnancy can result in antihuman platelet antigen antibodies. 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 ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6. The plasma preparations described are free of activated clotting factors and can therefore also. Immune thrombocytopenia purpura itp, also known as idiopathic thrombocytopenic purpura, is a type of thrombocytopenic purpura defined as an isolated low platelet count with a normal bone marrow in. Posttransfusion purpura in an africanamerican man due to. Jane doe is a 63 year old woman who presented 11 days after prbc transfusion with severe thrombocytopenia, altered mental status and diffuse petechiae. Logdberg, in blood banking and transfusion medicine second edition, 2007. Ptp, first described in 1961 3, is characterized by profound thrombocytopenia occurring 5 to 10 days after a blood transfusion. Intravenous immune globulin ivig order form reference table 1. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Post transfusion purpura ptp is a rare bleeding disorder of platelet alloimmunization that perhaps occurs as an anamnestic reaction. Immune thrombocytopenia purpura itp, also known as idiopathic thrombocytopenic purpura, is a type of thrombocytopenic purpura defined as an isolated low platelet count with a normal bone marrow in the absence of other causes of low platelets. Posttransfusion purpura is a rare syndrome characterized by severe thrombocytopenia and bleeding caused by alloimunization to human platelet specific antigens following a blood component transfusion.
Although there is evidence of a wide serological spectrum of culprit antibodies implicated, antihumanplateletantigen hpa 1a is the. Posttransfusion purpura ptp is a rare yet serious disease characterized by severe thrombocytopenia occurring after a blood transfusion. May 23, 20 posttransfusion purpura ptp is an uncommon, but potentially fatal, transfusion reaction characterized by profound thrombocytopenia and bleeding. Delayed immunemediated transfusion reactions occur. Cbo mandating organisations netherlands general practitioners association nhg netherlands internists association netherlands orthopaedic association netherlands association of anaesthesiology employees. Ptp appears with sudden severe thrombocytopenia, purpura, and often lifethreatening. Posttransfusion purpura is an immune mediated transfusion reaction with a low incidence in transfusion recipients. According to articles 12 a and 18, the transfusionsgesetz tfg, german transfusion act rules that the. Posttransfusion purpura is an acute, severe, thrombocytopenic state that has been described in 15 patients. Transfusions can be lifesaving for patients with severe anemia, thrombocytopenia, or deficiency of plasma components. Jan 22, 2020 posttransfusion purpura ptp is an uncommon but lifethreatening condition characterized by profound thrombocytopenia occurring.
Occurring after or as a consequence of blood transfusion. From department of pediatric hematooncology, great ormond street hospital. Crosssectional guidelines for therapy with blood components and. Background posttransfusion purpura is a rare syndrome characterized by. Seen most often in multiparous women with a platelet antibody formed during pregnancy, posttransfusion purpura manifests after an rbc or platelet transfusion. Prednisone therapy of posttransfusion purpura laurie j. Posttransfusion purpura is a very rare complication in which the platelet count falls rapidly 4 to 14 days after an rbc transfusion, causing moderate to severe thrombocytopenia. Post transfusion purpura ptp is a rare but well defined syndrome first characterized by shulman et al. Transfusion purpura, british journal of haematology 10. Interesting clinical and experimental observations are. 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.
Posttransfusion purpura ptp is a rare disorder with a historical incidence estimated to be between 1 in 25,000 to 100,000 transfusions. These maybe hemolytic, febrile, or due to contaminated blood. Posttransfusion purpura definition of posttransfusion. Thrombocytopenia occurs approximately one week after the administration of blood,1, 2 a. Blood transfusion is an important part of daytoday clinical practice. It is due to alloimmunization against platelet antigens which leads to acute profound thrombocytopenia. Post transfusion purpura ptp can occur in patients who have been previously sensitized to platelets by transfusion or through pregnancy. 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. 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. National users board sanquin blood supply organisation.
The problem of hemolytic shock is assuming a greater theoretical and practical significance because of the wider adaptation of blood transfusion. The hallmark of ptp is a potent immunoglobulin g antibody specific for a transfused plateletspecific alloantigen, usually located on glycoprotein iibiiia gpiibiiia. Together, the clinical and serologic findings established the diagnosis of post. Recapitulation of posttransfusion purpura by crossstrain. Release of free hgb and hgb free rbc stroma into circulation b stimulation of intrinsic coag pathway and bradykinin via. Posttransfusion purpura ptp posttransfusion purpura is a rare but potentially fatal condition that occurs when a transfusion recipient develops antibodies against platelets, resulting in.
Posttransfusion purpura ptp australian red cross lifeblood. Diagnosis and management of posttransfusion purpura. 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. 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. Transfusion reaction symptoms, diagnosis and treatment. 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. 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. The most frequently identified antibody is antipla1. Posttransfusion purpura successful treatment by exchange. Diagnosis, treatment, and reporting of adverse effects of. It causes a characteristic red or purple bruiselike rash and an increased tendency to bleed. Specialist working group for haematology proposed changes to the criteria for the clinical use of intravenous immunoglobulin in australia, second edition.
Itp idiopathic autoimmune thrombocytopenic purpura mohfw ministry of health and family welfare. Posttransfusion purpura ptp, first described in the late 1950s, 2,151,152 is a rare but serious complication of blood transfusion. Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions post transfusion purpura ptp level of. Posttransfusion purpura occurs when a person with an antiplatelet antibody is transfused with platelets expressing the corresponding antigen. Prednisone therapy of posttransfusion purpura annals of. Posttransfusion purpura ptp iron overload transfusion reactions. A rare but serious hemorrhagic complication following blood transfusion, which heretofore had been indistinguishable from idiopathic thrombocytopenic purpura, was elucidated by. However they need to be used judiciously as they are a limited resource and are not risk. Posttransfusion purpura ptp is a rare but well defined syndrome first characterized by. Posttransfusion purpura is a rare transfusionrelated complication that often goes undiagnosed. Post transfusion purpura ptp post transfusion purpura ptp specialty haematology haematology chapter 6 6 specific conditions level of.
Posttransfusion purpura cured by steroid therapy in a man. Posttransfusion purpura ptp is a rare bleeding disorder of platelet alloimmunization that perhaps occurs as an anamnestic reaction. Post transfusion purpura ptp is a rare and delayed transfusion. Free from infections that could be harmful to the recipient. Posttransfusion purpura practical transfusion medicine wiley. Complications of transfusion msd manual professional edition. Here, we report a case of post transfusion purpura in a 56. Transfusion medicine dr babak salimi hematologist and noninfectious transfusion reactions.
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. It is caused by alloimmunization against platelet antigens, antihpa1a being the most frequent antibody. Preoperative anaemia identification, assessment and management case study. It is characterized by the sudden onset of thrombocytopenia with purpura in the 710 days following a blood transfusion. Treatment for this condition consists of intravenous immunoglobulins, corticosteroids or plasmapheresis. Although this is rare and less common in males, it can occur, particularly as a patients comorbidities increased. Quick ivig reference sheet for pharmacists 1915 ivig. Post transfusion purpura ptp submitted by admin on wed, 20100310 12. 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. Transfusion medicine shahid beheshti university of. It occurs after transfusion of any plateletcontaining product red blood cells or platelets causing acute profound thrombocytopenia 1. Pdf posttransfusion purpura is a rare transfusionrelated. Transfusion medicine posttransfusion purpura ptp assessment.
Post transfusion purpura is a complication of blood product transfusion in which the recipient produces antiplatelet antibodies resulting in severe thrombocytopenia. Transfusion purpura, british journal of haematology. Dose to be based on ideal body weight ibw, unless actual body weight is less than ibw and obese patients more than 100kg or bmi 30 kgm2 use adjusted body weight abw obese patients. Therapy for posttransfusion purpura ptp is controversial. Cbo mandating organisations netherlands general practitioners association nhg. High dose intravenous immunoglobulin in post transfusion purpurachanges in bound and free. 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. Post transfusion purpura ptp is an uncommonly reported post. Clinical transfusion practice world health organization. Send out testing identified the patient has both hla class i antibodies and is homozygous for hpa1b platelet antigen, with an antibody to hpa1a.
Posttransfusion purpura ptp pdf national blood authority. Posttransfusion purpura an overview sciencedirect topics. High dose intravenous immunoglobulin in post transfusion. Transfusion of cellular blood products containing any platelets e. We have evaluated the effect of highdose igg hdigg in 11 ptp cases investigated in our institution and summarized the clinical.
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. Posttransfusion purpura ptp posttransfusion purpura is a rare but potentially fatal condition that occurs when a transfusion recipient develops antibodies against platelets, resulting in rapid destruction of both transfused and the patients own platelets and a severe decline in the platelet count. Its incidence is approximately 1 in 50 000100 000 blood transfusions and occurs more commonly in multiparous women. New codes centers for medicare and medicaid services. This guideline aims to provide practical advice on platelet transfusions to help clinicians to. Post transfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Posttransfusion purpura article about posttransfusion. Discuss the risks and adverse events associated with. 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.
Ptp, first described in 1961 3, is characterized by profound thrombocytopenia occurring 5 to 10 days. 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 post. Post transfusion purpura is a rare transfusion related complication that often goes undiagnosed.
Guidelines for the use of platelet transfusions a british society for. Ptp is a rare delayed transfusion reaction where a patient develops dramatic, sudden and selflimiting thrombocytopenia platelet counts transfusion. 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. Historical perspective, current status, recent advances and future directions. Posttransfusion purpura ptp is a rare and potentially fatal transfusion reaction leading to severe thrombocytopenia occurring approximately 1 week after blood transfusions. Summary posttransfusion purpura ptp is characterised by an acute episode of severe thrombocytopenia occurring about a week after a. Ptp is caused by alloimmunization to human platelet specific antigens following blood component transfusion.
Home posttransfusion purpura ptp pdf posttransfusion. Transfusion reactions blood transfusion hematology. Bleeding from mucous membranes and the gastrointestinal and urinary tracts is common. Post transfusion purpura ptp workup bloodworks northwest. Post transfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet. We report two cases of ptp and discuss the clinical presentation, diagnosis and management of this. It occurs primarily in women sensitized by pregnancy and is most commonly caused by antihuman platelet antigen1a antibodies. Posttransfusion definition of posttransfusion by medical. Posttransfusion purpura ptp is an uncommon but lifethreatening condition characterized by profound thrombocytopenia occurring. Posttransfusion purpura ptp is a delayed adverse reaction to a blood transfusion or platelet. They include acute haemolytic, febrile nonhaemolytic, allergic with or without anaphylaxis, and transfusionrelated acute lung injury trali.
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