Status:
Ready to upload
Record number:
1982
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
unknown/rare
Time to detection:
hours to days
Alerting signals, symptoms, evidence of occurrence:
Reduction in platelet counts on 3 episodes following IGIV transfusions with no signs of bleeding. On the third episode, administration of IVIG was interrupted due to dyspnea and chills, and platelets were transfused.
Demonstration of imputability or root cause:
An immunofluorescence test (PLT immunofluorescence test [PIFT]) applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient’s or healthy donors’ platelets (PLTs). A strong direct binding reaction was observed between the patient’s PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA. A strong positive reaction was also observed between the patient’s PLTs and Gammaplex and Omrigam.
Imputability grade:
1 Possible
Groups audience:
Keywords:
References:
Suggest new keywords:
IVIG, intravenous immunoglobulin, thrombocytopenia, acute thrombocytopenia, plasma derivates, immunofluorescence test, PLT immunofluorescence test, PIFT, monoclonal antibody immobilization of PLT antigen assay, MAIPA assay
Reference attachment:
Suggest references:
Intravenous immunoglobulin–induced acute thrombocytopenia. Transfusion. 2018 Feb;58(2):493-497
Thrombocytopenia secondary to passive transfer of anti-HPA 1a antibodies from male donor plasma. Transfusion Medicine, 2018, 28, 398–399
Expert comments for publication:
This is the first published case of possible IG related thrombocytopenia. More studies are needed of potential IG-related thrombocytopenia, including using large databases, to help validate current findings, investigate reasons, and understand the incidence and risk factors for possible IG-related thrombocytopenia.