A 12-Year-Old Girl Recently Diagnosed with Idiopathic Aplastic Anemia Is

A 12-year-old girl recently diagnosed with idiopathic aplastic anemia is brought to the clinic for follow-up.  Since her visit a week ago, the patient has developed red spots and bruising on her arms and legs.  Laboratory evaluation reveals an absolute neutrophil count of 420 cells/mm³ and platelet count of 7,000/mm³.  She is given a platelet transfusion.  Toward the end of the transfusion, the patient develops a rash on her chest that spreads to the rest of the body.  Temperature is 37.2 C (99.0 F) , blood pressure is 110/82 mm Hg, pulse is 90/min, and respirations are 18/min.  Pulse oximetry is 98% on room air.  Oropharynx examination is normal.  Lung examination is unremarkable.  Skin examination reveals a diffuse, urticarial rash along the trunk and extremities, along with pinpoint, nonblanching, red macules and bruises at the extremities.  The transfusion is stopped, and the patient receives diphenhydramine.  Vital signs remain stable over the next hour, and the rash improves slightly.  Which of the following is the best next step in evaluation of this patient's transfusion reaction?

A) Culture of the transfused product
B) Direct antibody (Coombs) test
C) No additional evaluation indicated
D) Peripheral blood smear
E) PT and PTT levels

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free