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Posttransfusion purpura

A survey of 13 cases

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Summary

Thirteen cases of posttransfusion purpura (PTP) which were diagnosed in Germany and Austria from 1977–1985 are described. All patients were women with a mean age of 58.6 years (range, 36–77 years). All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of PTP. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10×109/l and lasted between 3 and 60 days. All patients recovered from PTP. Optimal therapy consisted of administration of high-dose IgG. Twelve of the 13 patients had developed platelet-specific Zwa antibodies (eight of them together with HLA antibodies), in one Zwa positive individual only HLA antibodies were detectable. Five of six HLA-DR typed patients carried DR3 which is considered an immunogenetic risk factor in PTP. Clinical awareness of this rare, but serious iatrogenic transfusion complication is prerequisite for prompt diagnosis and improved therapy.

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Abbreviations

ELISA:

Enzyme-linked immunosorbent assay

HLA:

Human leukocyte antigen

LCTT:

Lymphocytotoxicity test

PAC3d:

Platelet-associated C3d

PAIFT:

Platelet adhesion immunofluorescence test

PAIgA:

Platelet-associated IgA

PAIgG:

Platelet-associated IgG

PAIgM:

Platelet-associated IgM

PRAT:

Platelet radioactive anti-IgG test

PTP:

Posttransfusion purpura

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Authors and Affiliations

  1. Institut für Klinische Immunologie und Transfusionsmedizin, Justus-Liebig-Universität, Giessen

    C. Mueller-Eckhardt, V. Kiefel & G. Mueller-Eckhardt

  2. Abteilung Dialyse und Nephrologie, Medizinische Universitätsklinik und Poliklinik, Homburg/Saar

    R. Bambauer

  3. Chirurgische Klinik Innenstadt und Chirurgische Poliklinik der Universität München, München

    J. Baur

  4. Zentrum für Innere Medizin I und III, Justus-Liebig-Universität, Giessen

    B. Behringhoff & D. Heinrich

  5. Krankenhaus Köln-Merheim, Medizinische Klinik, Köln

    U. Deuss

  6. Medizinische Universitätsklinik I, Köln

    H. O. Klein

  7. I. Medizinische Universitätsklinik, Wien

    K. Lechner & S. Panzer

  8. Rheumaklinik I, Wiesbaden

    D. Maas

  9. Landeskrankenhaus Feldkirch, Abteilung Innere Medizin, Feldkirch, Osterreich

    R. Sprenger

  10. Kreiskrankenhaus Bassum, Geburtshilflich-gynäkologische Abteilung, Bassum

    H. Stählin

  11. Zentrum für Frauenheilkunde und Geburtshilfe, Justus-Liebig-Universität, Giessen

    H. Vahrson

Authors
  1. C. Mueller-Eckhardt
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  2. V. Kiefel
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  3. G. Mueller-Eckhardt
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  4. R. Bambauer
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  5. J. Baur
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  6. B. Behringhoff
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  7. U. Deuss
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  8. D. Heinrich
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  9. H. O. Klein
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  10. K. Lechner
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  11. D. Maas
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  12. S. Panzer
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  13. R. Sprenger
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  14. H. Stählin
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  15. H. Vahrson
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Mueller-Eckhardt, C., Kiefel, V., Mueller-Eckhardt, G. et al. Posttransfusion purpura. Klin Wochenschr 64, 1198–1203 (1986). https://doi.org/10.1007/BF01728461

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  • DOI: https://doi.org/10.1007/BF01728461

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