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Post‐transfusion Purpura: a Serological and Immunochemical Study
Author(s) -
Pegels J. G.,
Bruynes E. C. E.,
Engelfriet C. P.,
Kr.von dem Borne A. E. G.
Publication year - 1981
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1981.tb07260.x
Subject(s) - platelet , antibody , medicine , serology , immunofluorescence , purpura (gastropod) , immunology , coombs test , autoantibody , biology , ecology
S ummary . By applying the platelet suspension immunofluorescence test (PSIFT), platelet‐specific alloantibodies responsible for post‐transfusion purpura were detected in eight patients within a period of 2 years. All patients were female and had previously received blood or had been pregnant. The platelet‐specific alloantibodies had the specificity anti‐Zw a in all the patients, who were all Zw(a ‐). In two patients the platelets were tested in the acute phase of the disease and found to be coated with IgG. In one patient an ether eluate was prepared from the platelets that reacted strongly with Zw(a +) platelets, but weakly with platelets from Zw b ‐homozygous individuals. The sera of these two patients, and of two others whose platelets were not directly tested, taken in the acute phase of the purpura, reacted strongly with Zw a ‐positive platelets. The four sera also reacted, however weakly, with Zw a ‐negative platelets, with autologous platelets taken during remission and with platelets from patients with Glanzmann's disease. It is postulated that Zw a ‐anti‐Zw a complexes, present in the eluate and the sera, caused the reaction with Zw a ‐negative platelets and the patients’own platelets. Immunochemical characterization of the post‐transfusion purpura antibodies showed that in all patients these were IgG, in two combined with IgM antibodies. Antibodies of the sub‐class IgG1 were found in all patients, sometimes together with IgG3. In the indirect immunofluorescence test with anti‐complement serum, the PTP antibodies in only four sera were able to fix complement. In only two of these sera were these complement‐binding antibodies detectable in the 51 Cr‐lysis technique and then in a much lower titre than in the immunofluorescence technique.