Fresh frozen plasma induced thrombocytopenia


Transfusions of blood products are common in medical practice and can be lifesaving in certain situations. Potentially life threatening reactions could occur and physicians should be alerted. Here we describe a case of thrombocytopenia that was induced by transfusion of fresh frozen plasma (FFP). A 52 years old male presented to the emergency department after two episodes of hematochezia that resolved spontaneously. Since he was anticoagulated for atrial fibrillation he was given a unit of FFP to reverse a slightly elevated INR. Within 6 hours from the administration of the FFP he developed an acute decrease only in his platelet count. He was managed conservatively and his thrombocytopenia started resolving gradually. After excluding other causes the potential diagnosis was fresh frozen plasma induced thrombocytopenia. The pathophysiologic mechanism is postulated to be immune mediated by passive transfer of antibodyies from the donor to the recipient. The antibodies that are described in the literature are anti-HPA-1a and anti-CD-36. We reported the event to the American Red Cross. Interestingly a male was the donor of the plasma while in all cases in the literature the donors are females with a prior history of pregnancy. Therefore this is the first reported case of a male blood donor whose blood product caused immune mediated thrombocytopenia post transfusion.

Share and Cite:

Drakaki, A. and Blanchard, E. (2013) Fresh frozen plasma induced thrombocytopenia. Case Reports in Clinical Medicine, 2, 123-125. doi: 10.4236/crcm.2013.22032.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bartholomew, J.R., Begelman, S.M. and Almahameed, A. (2005) Heparin-induced thrombocytopenia: Principles for early recognition and management. Cleveland Clinic Journal of Medicine, 72, 31-36. doi:10.3949/ccjm.72.Suppl_1.S31
[2] Pavenski, K., Webert, K.E. and Goldman, M. (2008) Consequences of transfusion of platelet antibody: A case report and literature review. Transfusion, 48, 1981-1989. doi:10.1111/j.1537-2995.2008.01796.x
[3] Kroll, H., Penke, G. and Santoso, S. (2005) Functional heterogeneity of alloantibodies against the human platelet antigen (HPA)-1a. Thrombosis and Haemostasis, 94, 1224-1229.
[4] Van Schravendijk, M.R., Handunnetti, S.M., Barnwell, J.W. and Howard, R.J. (1992) Normal human erythrocytes express CD36, an adhesion molecule of monocytes, platelets, and endothelial cells. Blood, 80, 2105-2114.
[5] Morishita, K., Wakamoto, S., Miyazaki, T., Sato, S., Fujihara, M., Kaneko, S., Yasuda, H., Yamamoto, S., Azuma, H., Kato, T. and Ikeda, H. (2005) Life-threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing antiCD36 (Naka) isoantibody. Transfusion, 45, 803-806. doi:10.1111/j.1537-2995.2005.04320.x
[6] Al-Shahi, R., Mason, J.C., Rao, R., Hurd, H., Thompson, E.M., Haskard, D.O. and Davies, K.A. (1997) Systemic lupus erythematosus, thrombocytopenia, microangiopathic haemolytic anemia and anti-CD36 antibodies. British Journal of Rheumatology, 36, 794-798. doi:10.1093/rheumatology/36.7.794
[7] Carr, J.M., Kruskall, M.S., Kaye, J.A. and Robinson, S.H. (1986) Efficacy of platelet transfusions in immune thrombocytopenia. American Journal of Medicine, 80, 1051-1054. doi:10.1016/0002-9343(86)90664-9

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.