Post Transfusion Purpura (PTP)

Post Transfusion Purpura (PTP) is a rare but serious complication of transfusion in which thrombocytopaenia and purpura (bleeding underneath the skin) develops 5 – 10 days post transfusions as a result of destruction of transfused as well as autologous platelets. PTP is more common in multiparous females due to previous sensitisation during pregnancy and is due to anti-HPA antibodies boosted by the transfusion. Studies have also shown that pan specific anti HPA antibodies are present during the thrombocytopaenic phase and these transient antibodies are probably responsible for the autologous platelet destruction.

 

Laboratory investigations for PTP include confirmation of circulating anti-HPA antibodies in the patient. HPA antibody testing techniques most commonly used include the flowcytometric Platelet immunofluorescence Test (PIFT) and the Monoclonal Antibody specific Immobilisation of Platelet Antigens (MAIPA) test which uses platelet antigen specific monoclonal antibodies to specifically capture platelet antigens and is therefore useful for differentiating HPA from HLA antibodies.

 

PTP is treated with IV Ig with plasmapheresis as a second line treatment.

 

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