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

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...

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Published inLaboratory medicine Vol. 50; no. 4; pp. 396 - 400
Main Authors Milito, Chelsea, Masel, Debra, Henrichs, Kelly, Schmidt, Amy E, Kirkley, Scott, Aljitawi, Omar, Becker, Michael, Blumberg, Neil, Refaai, Majed A
Format Journal Article
LanguageEnglish
Published England Oxford University Press 01.11.2019
Subjects
Autoantibodies - blood
Biological products
Blood platelets
Case reports
Diagnosis, Differential
Drug-Related Side Effects and Adverse Reactions - pathology
Female
Histocompatibility antigens
HLA histocompatibility antigens
Humans
Middle Aged
Monoclonal antibodies
Multiple myeloma
Platelet Count
Purpura, Thrombocytopenic, Idiopathic - pathology
Stem Cell Transplantation - adverse effects
Stem cells
Targeted cancer therapy
Thrombocytopenic purpura
Transfusion
Transfusion Reaction - diagnosis
Transfusion Reaction - pathology
Transplantation
platelet
transfusion
transfusion complications
thrombocytopenia
thrombocytopenic purpura
post-transfusion purpura
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Summary: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.
Bibliography:ObjectType-Case Study-2
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ISSN:0007-5027
1943-7730
DOI:10.1093/labmed/lmz004