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Post-Transfusion Purpura: Current Perspectives

Authors Hawkins J, Aster RH, Curtis BR

Received 21 September 2019

Accepted for publication 22 November 2019

Published 9 December 2019 Volume 2019:10 Pages 405—415

DOI https://doi.org/10.2147/JBM.S189176

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Martin H. Bluth


Jaleah Hawkins,1 Richard H Aster,2,3 Brian R Curtis2,3

1Versiti, Blood Center of Michigan, Grand Rapids, MI, USA; 2Versiti, Blood Center of Wisconsin, Milwaukee, WI, USA; 3Blood Research Institute, Milwaukee, WI, USA

Correspondence: Brian R Curtis
Versiti, Blood Center of Wisconsin, P.O. Box 2178, Milwaukee, WI 53201-2178, USA
Tel +1 414 937 6087
Fax +1 414 937 6242
Email brcurtis@versiti.org

Abstract: Post transfusion purpura (PTP) is an uncommonly reported post transfusion adverse event that can present with severe thrombocytopenia; sometimes resulting in significant bleeding and hemorrhage. Its diagnosis can be elusive given its substantial symptomatic overlap with other thrombocytopenic syndromes. Underdiagnosis and underreporting make the true incidence of disease difficult to define. While clinical suspicion is key, laboratory evidence of platelet-targeted antibodies and identification of the antigen(s) they recognize are necessary to confirm the diagnosis. A curious aspect of PTP is paradoxical destruction of both transfused and autologous platelets. Although the first case was reported over 50 years ago, this aspect of PTP pathogenesis is still not fully understood and is widely debated. Several theories exist, but conclusive evidence to support most is lacking. Despite limited understanding of disease incidence and etiology, treatment with IVIG (Intravenous Immunoglobulin) has become standard practice and can be highly effective. Although recurrence is rare, precautions should be taken if patients with a history of PTP require transfusions in the future.

Keywords: thrombocytopenia, platelet antibodies, transfusion reactions

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