Immunoglobulin classes and subclasses of platelet antibodies in a case of post-transfusion purpura

L. Porretti, F. Marangoni, E. Cofrancesco, M. C. Neri, P. Rebulla

Research output: Contribution to journalArticle

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Abstract

A multiparous white woman developed severe thrombocytopenia following transfusion of red blood cells. Six ineffective platelet transfusions (a total of 42 random donor concentrates) were given from day 0 to day +6, high-dose steroids from day +1, progressively tapered until day +30, and a total of 150 g of intravenous immunoglobulins from day +2 to day +6. As platelet count had not increased significantly by day +8, four plasma exchange procedures, each consisting of 2,000 ml of plasma exchanged with 5% albumin solution, were performed on days +8, +10, +14 and +18. Platelet count was 5, 50,100 and 234 x 109/l on days +8, +14, +26 and +32 (discharge), respectively. The patient's acute phase serum contained increased levels of platelet alloantibodies with anti-HPA-1a (P1A1, Zwa) specificity and a titer of 3,200. IgG1, IgG2 and IgG3 subclasses of platelet-reactive antibodies in the patient's serum were elevated, whereas IgG4, IgM and IgA were within the reference values. Levels of IgG1, IgG2 and IgG3 of antiplatelet antibodies showed a marked and parallel reduction during treatment, but were still above the reference values at the end of treatment and 1 year later, when the patient platelet count was normal. Although a failure of intravenous immunoglobulins cannot be proven in this case, plasma exchange seems to have contributed more than intravenous immunoglobulins to clinical remission.

Original languageEnglish
Pages (from-to)276-281
Number of pages6
JournalVox Sanguinis
Volume63
Issue number4
Publication statusPublished - 1992

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Purpura
Immunoglobulin Isotypes
Blood Platelets
Immunoglobulin G
Antibodies
Intravenous Immunoglobulins
Platelet Count
Plasma Exchange
Reference Values
Isoantibodies
Erythrocyte Transfusion
Platelet Transfusion
Serum
Thrombocytopenia
Immunoglobulin A
Immunoglobulin M
Albumins
Steroids
Tissue Donors
Therapeutics

ASJC Scopus subject areas

  • Hematology

Cite this

Immunoglobulin classes and subclasses of platelet antibodies in a case of post-transfusion purpura. / Porretti, L.; Marangoni, F.; Cofrancesco, E.; Neri, M. C.; Rebulla, P.

In: Vox Sanguinis, Vol. 63, No. 4, 1992, p. 276-281.

Research output: Contribution to journalArticle

Porretti, L. ; Marangoni, F. ; Cofrancesco, E. ; Neri, M. C. ; Rebulla, P. / Immunoglobulin classes and subclasses of platelet antibodies in a case of post-transfusion purpura. In: Vox Sanguinis. 1992 ; Vol. 63, No. 4. pp. 276-281.
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