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Post‐transfusion purpura in a patient with HPA‐1a and GPIa/IIa antibodies

summary.  Post‐transfusion purpura is a rare bleeding disorder characterized by severe and sudden thrombocytopenia within 3–12 days after blood transfusion. Typically, preformed antibodies directed against human platelet antigens, especially HPA‐1a, are associated with the clinical symptoms. A 46‐year‐old female presenting to the hospital with acute progressive kidney insufficiency and anaemia received two units of packed red blood cells (RBC) within 2 days. On day 7, platelet count felt from 414 to 189 × 109 L−1 and 1 day later dropped to 4 × 109 L−1. Four platelet concentrates were applied without success. After serological confirmation of an HPA‐1a antibody, the patient was treated with intravenous gamma immunoglobulin (ivIgG), and the platelet count increased to normal values on day 17. In addition to the persisting HPA‐1a alloantibody, an antibody reactive with GPIa/IIa of HPA‐5a‐ and HPA‐5b‐positive platelets was detected during the acute phase of thrombocytopenia. After complete remission, the patient was transfused with four units of packed RBC from HPA‐1a‐negative donors, and platelet counts remained normal.