Post-transfusion purpura: a survey of 12 Danish cases with special reference to immunoglobulin G subclasses of the platelet antibodies

Transfus Med. 1994 Mar;4(1):1-8. doi: 10.1111/j.1365-3148.1994.tb00236.x.

Abstract

The clinical and immunological data of 12 Danish cases of post-transfusion purpura (PTP) are summarized. All patients but one were women. All except one had thrombocytopenic purpura which occurred 4-11 days after transfusion, usually with a nadir of the platelet count below 10 x 10(9) 1(-1). The typical haemorrhagic symptoms were cutaneous bleedings, melena and haematuria lasting from 3 to 12 days. The time until normalization of platelet count varied from 3 to 50 days after onset. One patient had recurrence of PTP and one patient died due to intracranial haemorrhage. Ten of the HPA-1a negative patients (83%) had platelet-specific HPA-1a antibodies and two HPA-1a positive individuals had anti-HPA-1b antibodies. In 10 patients, HLA antibodies were also detectable and in one patient a delayed haemolytic transfusion reaction due to anti-E was seen. All of seven patients investigated had anti-HPA antibodies of both IgG1 and IgG3 subclasses during the thrombocytopenic period while all of 10 patients had anti-HPA of only the IgG1 subclass after recovery from PTP. Thus, the destruction of autologous platelets in PTP seems to be associated with the presence of anti-HPA of the IgG3 subclass which may be of importance in the pathogenesis of PTP.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibody Specificity
  • Antigens, Human Platelet / analysis
  • Antigens, Human Platelet / immunology*
  • Autoimmune Diseases / etiology*
  • Autoimmune Diseases / immunology
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / mortality
  • Denmark
  • Female
  • HLA Antigens / immunology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / classification
  • Immunoglobulin G / immunology*
  • Integrin beta3
  • Isoantibodies / blood
  • Isoantibodies / immunology*
  • Male
  • Middle Aged
  • Parity
  • Postoperative Complications
  • Purpura, Thrombocytopenic / complications
  • Purpura, Thrombocytopenic / etiology*
  • Purpura, Thrombocytopenic / immunology
  • Recurrence
  • Risk Factors
  • Transfusion Reaction*

Substances

  • Antigens, Human Platelet
  • HLA Antigens
  • ITGB3 protein, human
  • Immunoglobulin G
  • Integrin beta3
  • Isoantibodies