Post-Transfusion Purpura Mimicking Idiopathic Thrombocytopenic Purpura: A Case Report

Abstract

The main clinical distinction between post-transfusion purpura (PTP) and idiopathic thrombocytopenic purpura (ITP) is the sudden development of severe thrombocytopenia in the days after transfusion. Herein, we report the case of a 53-year-old Caucasian woman who developed multiple myeloma (MM) after peripheral blood-stem-cell transplant (PBSCT), along with severe thrombocytopenia (with a nadir of 1 × 109/L); she also experienced severe adverse events after each platelet transfusion, including the first one. These reactions were absent with any other transfused blood products. The results of an human leukocyte antigen (HLA) class-1 panel reactive antibody assay were 0%, and the results of a platelet-antibody screening assay were positive for HLA class-1 antibodies and glycoprotein (Gp)IIb/IIIa antibodies. Her platelet count reached 42 × 109 per L on day 50, after rituximab on day 22 and daratumumab on day 29. Her clinical scenario was most consistent with the course of PTP.

Investigation of the correlation between platelet antibodies and peripheral blood cytopenia in patients with hepatocellular carcinoma

“…Platelet antibodies bear a significant correlation with various conditions such as fever nonhemolytic transfusion reactions, platelet transfusion failure, post-transfusion purpura, fetal and neonatal alloimmune thrombocytopenia, transfusion-related acute lung injury, as well as transplant rejection and survival 1 – 7 . The incidence of platelet antibody in both tumor patients and stem cell transplantation patients approximately ranges from 10 to 66% 8 – 10 .…”