Diagnosis and management of post‐transfusion purpura in the acute trauma setting: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: Background Post‐transfusion purpura (PTP) is a rare and severe transfusion reaction characterized by rapid‐onset thrombocytopenia, typically occurring 1–2 weeks after platelet or RBC transfusion. While PTP is commonly seen in patients with prior pregnancies or transfusions, its occurrence in trauma patients has rarely been reported. We present a case highlighting the challenges of PTP diagnosis and management in the post‐trauma setting. Case Report A 38‐year‐old female was airlifted to Harborview Medical Center, Seattle, WA, USA, following a motor vehicle accident, requiring administration of blood products via massive transfusion protocol. On hospital Day 8, she developed abrupt and significant thrombocytopenia, with a drop in platelets from 157 × 10 3 /uL to 3 × 10 3 /uL by hospital Day 9. Surgical intervention, anticoagulation, and additional platelet transfusions were held for five days while a PTP workup was ordered and intravenous immunoglobulin (IVIG) therapy started. Despite concerns around halting acute surgical care, the platelet count steadily improved after 5 days, allowing for reinitiation of surgical intervention. Additional testing revealed the presence of anti‐HPA‐1a antibodies, confirming the diagnosis of PTP. Discussion This case emphasizes the complexity of diagnosing PTP in the acute trauma setting following massive transfusion protocol. Effective communication between the transfusion medicine, hematology/oncology, and trauma surgery teams was crucial to successfully manage this patient, highlighting the importance of a supportive multidisciplinary approach in these complex clinical scenarios.
Source: Transfusion
DOI: 10.1111/trf.18443
Authors: Tara Krishnan, Thomas Ma, Margery Gang, Hui Xiao Chao, Nicholas Giustini, John Hess
Language: English
Subfield: Biochemistry
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4415137271