Post-transfusion purpura (PTP) is an infrequent complication of blood transfusion. It has been most commonly associated with the transfusion of red blood cells and whole blood but has also been seen in platelet and plasma transfusions. It is characterized by a rapid onset of thrombocytopenia or decreased platelet count, which results from the production of a platelet alloantibody. Platelet counts are usually less than 10,000/mcL. Reactions occur around 7 to 14 days post-transfusion. Patients present with purpura, bleeding from the mucous membranes, gastrointestinal area, and/or urinary tract. Melena and vaginal bleeding have also been reported. The thrombocytopenia is usually self-limiting.
Platelet counts and coagulation studies aid in the diagnosis. Patients can also be tested for platelet-specific antibodies, human leukocyte antigen (HLA) antibodies, and lymphocytotoxic antibodies. The differential diagnosis includes other causes of thrombocytopenia.
