Posttransfusion purpura

Profound thrombocytopenia occurring 5-10d after blood or platelet transfusion. Usually due to high titre of anti-HPA-la antibody in HPA-1a -ve patient.

Features

• Multiparous 3 most commonly (previous pregnancies or transfusions).

• Caused by platelet-specific alloantibodies (usually anti-HPA-la).

• Platelets 55 with associated bleeding/bruising—may be severe and even life threatening.

Management

• Plasma exchange worth considering.

• If platelet transfusion needed, use random donor platelets (no evidence that HPA-1a superior).

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