Abciximab-induced acute profound thrombocytopenia postpercutaneous coronary intervention

BMJ Case Rep. 2017 Jul 14:2017:bcr2017221182. doi: 10.1136/bcr-2017-221182.

Abstract

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.

Keywords: Cardiovascular System; Contraindications And Precautions; Drug Interactions; Interventional Cardiology; Safety.

Publication types

  • Case Reports

MeSH terms

  • Abciximab
  • Angioplasty
  • Antibodies, Monoclonal / adverse effects*
  • Chest Pain / etiology
  • Diagnosis, Differential
  • Humans
  • Immunoglobulin Fab Fragments / adverse effects*
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / therapy*
  • Platelet Aggregation Inhibitors / adverse effects*
  • Thrombocytopenia / blood
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / diagnosis*

Substances

  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Platelet Aggregation Inhibitors
  • Abciximab