Zusammenfassung
Es werden die ersten beiden Patienten mit posttransfusioneller thrombozytopenischer Purpura beschrieben, die in Österreich und in Deutschland diagnostiziert werden konnten. Beide Patienten waren Frauen im Alter von 51 und 60 Jahren. Die Purpura wurde durch Bluttransfusionen ausgelöst mit einer Latenzzeit von zwei bzw. sieben Tagen. Die thrombozytopenische Phase dauerte 22 bzw. länger als 60 Tage. In einem Fall bestand neben der Thrombozytopenie eine Agranulozytose infolge einer vorübergehenden Knochenmarksinsuffizienz. Beide Patienten waren negativ für das thrombozytenspezifische Antigen PlA1 (= Zwa). Ihr Serum enthielt sowohl PlA1- als auch starke HLA-Antikörper. Die klinischen und serologischen Befunde beider Patienten werden eingehend dargestellt. Eine Literaturübersicht mit bisher 25 beschriebenen Fällen ist angefügt.
Summary
Two patients with post-transfusion thrombocytopenic purpura are described, the first cases recognized in Austria and Germany. Both patients were female, 51 and 60 years of age. The purpura was evoked by blood transfusions with a latent period of 2 and 7 days. The thrombocytopenic episode lasted for 22 and over 60 days. In one case, thrombocytopenia was associated with agranulocytosis due to transient bone marrow failure. Both patients were negative for the platelet-specific antigen PlA1 (= Zwa). Their sera contained PlA1 as well as potent HLA antibodies. Detailed clinical and serological data are presented. The literature with a total of 25 cases so far reported is surveyed.
References
Abramson N, Eisenberg PD, Aster RH (1974) Post-transfusion purpura: Immunologic aspects and therapy. N Engl J Med 291: 1163
Cimo PL, Aster RHP (1972) Post-transfusion purpura: Successful treatment by exchange transfusion. N Engl J Med 287: 290
Colombani J, D'Amaro J, Gabb B, Smith G, Svejgaard A (1971) International agreement on a microtechnique of platelet complement fixation. Transplant Proc 3: 121
Dainer PM, Canada ED (1977) Post-transfusion purpura and multiple transfusions. Br Med J II: 999
Dubarry JJ, Moulinier J, Quinton A, Labat JP, Merle MC (1970) Un cas de purpura thrombopénique posttransfusionnel. Bordeaux Medical 4: 911
Eisenberg PD, Abramson N (1977) Post-transfusion purpura revisited. N Engl J Med 296: 515
Gerstner JB, Smith MJ, Davis KD, Cimo PL, Aster RH (1979) Post-transfusion purpura: Therapeutic failure of PlA1-negative platelet transfusion. Am J Hematol 6: 71
Gockerman JP, Shulman NR (1973) Isoantibody specifity in post-transfusion purpura. Blood 41: 817
Heinrich D, Kessler C, Mueller-Eckhardt C (1977) A comparative analysis of methods suitable for detection of platelet alloantibodies. Vox Sang 32: 325
Howard JE, Glassberg AB, Perkins HA (1976) Post-transfusion thrombocytopenic purpura: A case report. Am J Hematol 1: 339
Krueger S, Davies RB (1976) Post-transfusion purpura. Nebr Med J 61: 413
Loghem JJ van, Dorfmeijer H, Hart M van der, Schreuder F (1959) Serological and genetical studies on a platelet antigen (Zw). Vox Sang 4: 161
Morrison FS, Mollison PL (1966) Post-transfusion purpura. N Engl J Med 275: 243
Morse EE (1968) Post-transfusion thrombocytopenic purpura. Johns Hopkins Med J 121: 365
Mueller-Eckhardt C, Schulz G, Sauer KH, Dienst C, Mahn I (1978) Studies on the platelet radioactive anti-immunoglobulin test. J Immunol Methods 19: 1
Nicholls RJ, Davies P, Kenwright MG (1970) Thrombocytopenic purpura after blood transfusion. Br Med J II: 581
Shulman NR, Aster RH, Leitner A, Hiller MC (1961) Immunoreactions involving platelets. V. Post-transfusion purpura due to a complement-fixing antibody against a genetically controlled platelet antigen. A proposed mechanism for thrombocytopenia and its relevance in “autoimmunity”. J Clin Invest 40: 1597
Shulman NR, Marder VJ, Hiller MC, Collier EM (1964) Platelet and leukocyte iso-antigens and their antibodies: serologic, physiologic and clinical studies. Prog Hematol 4: 222
Svejgaard A, Pedersen MF, Hansen OH, Kissmeyer-Nielsen, F (1967) Post-transfusion purpura caused by a specific platelet antibody. Dan Med Bull 14: 41
Svejgaard A (1969) Iso-antigenic systems of human blood platelets. A survey. Ser Hematol II: 3
Terasaki P, McClelland J, McCurdy B (1973) Microdoplet lymphocyte cytotoxicity test; In: Ray, Hare, Kayhoe (eds) Manual of tissue typing techniques. TIB, NIAID, NIH, Bethesda 1973, p 54
Vaughan-Neil EF, Ardeman S, Sevan G, Blakeman AC, Jenkins WJ (1975) Post-transfusion purpura associated with unusual platelet antibody (anti-PlB1). Br Med J I: 436
Willumsen L, Thyme S (1977) Posttransfusionel purpura. Ugeskr Laeger 139: 1293
Zeigler Z, Murphy S, Gardner FH (1975) Post-transfusion purpura: A heterogeneous syndrome. Blood 45: 529
Zucker MB, Ley AB, Borrelli J, Mayer K, Firmat J (1959) Thrombocytopenia with a circulating platelet agglutinin, platelet lysin and clot retraction inhibitor. Blood 14: 148
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Mueller-Eckhardt, C., Lechner, K., Heinrich, D. et al. Post-transfusion thrombocytopenic purpura: Immunological and clinical studies in two cases and review of the literature. Blut 40, 249–257 (1980). https://doi.org/10.1007/BF01080184
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DOI: https://doi.org/10.1007/BF01080184