Posttransfusion purpura

Rare process manifested by sudden onset of thrombocytopenia in a patient who has recently received red blood cells, platelets or plasma within one week.

Antibodies against human platelet antigen PL(A1) are detected in most patients with this process.

Patients are usually multiparous women or persons who have received previous transfusions.

Severe thrombocytopenia and bleeding is typical.

Intravenous gamma globulin 1 g per kilogram per day for two days is effective therapy.

Platelet transfusions not indicated, but in the presence in severe bleeding may be considered.

HLA matched platelet transfusions are preferable to random platelet transfusions.

Plasma exchange, or spun back to me can be considered in refractory cases.

PL (A1) negative or washed blood products should be used in subsequent transfusions.

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