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Posttransfusion purpura: Therapeutic failure of Pl Al ‐negative platelet transfusion
Author(s) -
Gerstner James B.,
Smith Martin J.,
Davis Kent D.,
Cimo Philip L.,
Aster Richard H.
Publication year - 1979
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830060110
Subject(s) - platelet , plasmapheresis , medicine , purpura (gastropod) , fulminant , platelet transfusion , immunology , blood transfusion , titer , whole blood , lytic cycle , gastroenterology , antibody , biology , virus , ecology
The effect of platelet type‐specific transfusion in posttranfusion purpura is reported. Seven days after receiving 4 units of whole blood during total hip replacement a 69‐year‐old woman developed fulminant thrombocytopenic purpura. Her undiluted serum inhibited the clot retraction of Pl Al ‐positive, but not Pl Al ‐negative blood. Anti‐Pl Al titer of her serum, determined by 51 Cr platelet lysis technique, was 1:64. The serum had no lytic activity against platelet‐rich plasma from two Pl Al ‐negative donors. No anti‐HLA antibody was detectable in the serum by lymphocytotoxicity technique, and serum obtained prior to transfusions had no platelet lytic activity. Four units of Pl Al ‐negative platelet concentrate were administered, the first instance in which this treatment has been used. No rise in platelet count ensued, and the patient succumbed to purpura. Exchange transfusion or plasmapheresis remain the treatments of choice.