Post-Transfusion Purpura

Aka: Post-Transfusion Purpura, Post Transfusion Purpura

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II. Epidemiology

  1. Rare, severe Thrombocytopenia occurring within 5-15 days of Platelet Transfusion
  2. More common in Multiparous women who have not previously received Platelet Transfusion

III. Pathophysiology

  1. Alloantibody reaction to human PlateletAntigen (HPA)-1a
  2. Sensitization occurs during pregnancy (or from prior Platelet Transfusion)

IV. Course

  1. Resolves over days to weeks

V. Differential Diagnosis

  1. Drug induced Thrombocytopenia
  2. Sepsis
  3. Dilutional Thrombocytopenia
    1. Occurs with Massive Transfusion Protocol (e.g. 15 units pRBC in prior 24 hours) if not balanced
    2. Onset within 24 hours (Contrast with 5-15 days in Post-Transfusion Purpura)

VI. Management: Severe Thrombocytopenia and Bleeding Complications

  1. Similar management to Immune Thrombocytopenic Purpura
  2. Corticosteroids
  3. Intravenous Immunoglobulin (IV IG)
  4. Plasma echange may be considered

VII. Complications

  1. Life threatening Hemorrhage may occur

VIII. References

  1. Dave, Hoag, Jundoria and Lopez (2026) Crit Dec Emerg Med 40(2): 26-35

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