Augustina Isioma Ikusemoro: An Underrecognized Cause of Severe Thrombocytopenia Following Transfusion
Augustina Isioma Ikusemoro, Hematology and Transfusion Medicine Specialist at Sharjah Blood Transfusion and Research Center, shared a post on Linkedin:
“Sudden severe thrombocytopenia after transfusion?
Think Post-Transfusion Purpura (PTP).
One of the most under-recognized yet critical delayed transfusion reactions in clinical practice is Post-Transfusion Purpura (PTP) — and missing it can delay life-saving treatment.
What is PTP?
A rare, immune-mediated complication that typically appears 5–10 days after transfusion, most often in previously pregnant or transfused patients, especially women.
What causes it?
The development of platelet alloantibodies, commonly anti-HPA-1a, which trigger destruction of both transfused platelets and the patient’s own platelets.
What happens clinically?
- Sudden severe thrombocytopenia (less than 10 × 10⁹/L)
- Petechiae, purpura, mucosal bleeding
- Risk of serious hemorrhage if untreated
Key diagnostic clues.
- Recent transfusion history
- Critically low platelet count
- Detection of anti-platelet antibodies
- Exclusion of other causes like TTP and ITP
Treatment is urgent — and effective when started early.
- IVIg (first-line therapy)
- Steroids as adjunct
- Plasma exchange in refractory cases
Avoid platelet transfusion unless life-threatening bleeding.
The most important takeaway?
PTP is treatable — but only if recognized early.
When unexplained severe thrombocytopenia appears days after transfusion, pause and consider PTP.
Early recognition saves lives.
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