Post-transfusion purpura: response to steroids and association with red blood cell and lymphocytotoxic antibodies

Abstract

An unusual patient with post-transfusion purpura is described who had a rapidly rising platelet count with high dose steroid [methylprednisolone] treatment in the presence of an increasing anti-PlA1 [platelet antigen] antibody titer. A platelet autoantibody could not be detected by a radioactive platelet antiglobulin test, but autologous platelet survival data indicated a compensated thrombolytic state in the recovery period. In spite of the failure to demonstrate a platelet autoantibody, the rapid response to steroids in association with a reduced platelet survival is compatible with an autoimmune platelet destructive process. In addition to PlA1 platelet antibodies, this patient had an associated anamnestic recall of multispecific red cell and lymphocytotoxic antibodies.