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BMJ Case Reports 2017; doi:10.1136/bcr-2017-221182
  • Reminder of important clinical lesson
  • CASE REPORT
  • Case report

Abciximab-induced acute profound thrombocytopenia postpercutaneous coronary intervention

  1. Shilpa Junna2
  1. 1Department of Medicine, College of Medicine, University of Arizona, Tucson, USA
  2. 2Department of Internal Medicine, University of Arizona, Tucson, USA
  3. 3Department of Medicine, Arizona Center on Aging, University of Arizona, Tucson, USA
  1. Correspondence to Dr Sehem Ghazala, sghazala{at}deptofmed.arizona.edu
  • Accepted 13 June 2017
  • Published 14 July 2017

Summary

Abciximab (c7E3 Fab) is one of the three potent intravenous glycoprotein IIb/IIIa receptor inhibitors (along with eptifibatide and tirofiban) that have shown significant positive outcomes when used in patients with intracoronary thrombus. However, major side effects have been reported with its use including hypotension, major bleeding and thrombocytopenia. This case is a 53-year-old man presenting with acute chest pain diagnosed with non-ST-elevation myocardial infarction, who underwent percutaneous coronary intervention with abciximab and heparin infusion and developed acute profound thrombocytopenia (platelet count <20,000/L) within 9 hours of infusion. This case demonstrates the importance of routinely monitoring the platelet count prior to and 2–4 hours following abciximab infusion and differentiating other causes of acute profound thrombocytopenia, particularly pseudothrombocytopenia and heparin-induced thrombocytopenia.

Footnotes

  • Contributors TG wrote the discussion and SG wrote the case presentation and care for the patient. RW wrote the abstract and introduction. SJ cared for the patient and helped with full template editing.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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