Posttransfusion purpura sans purpura: A novel presentation

Posttransfusion purpura (PTP) is a rare condition that develops 5-10 days after transfusion of platelet containing blood component. Temporal relationship to blood transfusion, thrombocytopenia, and purpuric rashes with or without bleeding manifestation, supported by the serological presence of antiplatelet antibodies, are characteristic of PTP. We, herein, report a case of posttransfusion thrombocytopenia without purpuric rashes or bleeding symptoms, which is a rare presentation. A 44-year-old multiparous female, being treated for menorrhagia, who was transfused with three packed red blood cell units developed significant thrombocytopenia on day 8 after transfusion of the first unit. Her coagulation profile was normal. No purpuric rashes or bleeding manifestation was seen. Serum revealed the presence of antiplatelet antibodies on performing platelet antibody screen. Her platelet count improved from day 9 and reached above 50,000/μ l on day 10. She was managed conservatively with frequent monitoring for bleeding manifestations and blood counts.