A case of platelet transfusion refractoriness occurring after platelet transfusion for tooth extraction

Platelet transfusion recipients occasionally become alloimmunized to foreign HLA and HPA antigens, impairing their responses to further platelet transfusions. Anti-HLA and anti-HPA antibodies, which are produced during pregnancy and blood transfusion, often cause platelet transfusion refractoriness (PTR). We report a case of PTR occurring after platelet transfusion for tooth extraction. A 78-year-old woman was referred to our department because of tooth pain. She had chronic hepatitis and thrombocytopenia, as well as a history of blood transfusion on two occasions. We planned extraction of the left mandibular premolars and left maxillary second molar after the platelet transfusion. After a preoperative platelet transfusion of 20 units was performed, her platelet count decreased. Tests for anti-HLA antibody suggested the possibility of PTR. She had a good response to transfusion of HLA-matched platelets, and the tooth extraction was carried out successfully.