Skip to content
2000
  1. Home
  2. A-Z Publications
  3. New Emirates Medical Journal
  4. Volume 4, Issue 1
  5. Article
Volume 4, Issue 1
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882
file format pdf download PDF
side by side viewer icon HTML

Abstract

Introduction

Drug-induced thrombocytopenia (DIT) is a condition characterized by low platelet count after administration of a variety of drugs. It is most commonly seen in patients treated with heparin. Its diagnosis is complicated when more than one DIT-causing drug is co-administered. Patients with thrombocytopenia may present with minor or major hemorrhages, depending on the severity of the recess of the platelets.

Case Description

We herein report an uncommon presentation of acute IIb/IIIa glycoprotein inhibitor-induced thrombocytopenia in a 50-year-old male who suffered from myocardial infarction. Serial complete blood counts revealed low platelet counts, rising after discontinuation of the administered IIb/IIIa inhibitor. Recovery was prompt, complete, and sustained with minimal costs.

Conclusion

This report highlights the importance of prompt recognition of severe thrombocytopenia caused by IIb/IIIa inhibitors, particularly tirofiban, by measuring platelet count before and after the initiation of tirofiban, as it can be resolved by the interruption of its infusion and early supportive treatment.

© 2023 Bentham Science Publishers
© 2023 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
Loading

Article metrics loading...

/content/journals/nemj/10.2174/04666230308141033
2023-05-03
2025-01-19

  • From This Site

    /content/journals/nemj/10.2174/04666230308141033
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

/deliver/fulltext/nemj/4/1/NEMJ-4-1-E080323214477.html?itemId=/content/journals/nemj/10.2174/04666230308141033&mimeType=html&fmt=ahah

References

  1. RahmanN. JafaryF.H. Vanishing platelets: Rapid and extreme tirofiban-induced thrombocytopenia after percutaneous coronary intervention for acute myocardial infarction.Tex. Heart Inst. J.201037110911220200641
     [Google Scholar]
  2. RoffiM. PatronoC. ColletJ.P. MuellerC. ValgimigliM. AndreottiF. BaxJ.J. BorgerM.A. BrotonsC. ChewD.P. GencerB. HasenfussG. KjeldsenK. LancellottiP. LandmesserU. MehilliJ. MukherjeeD. StoreyR.F. WindeckerS. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.Eur. Heart J.201637326731510.1093/eurheartj/ehv32026320110
     [Google Scholar]
  3. YurtdaşM. YaylaliY.T. AladağN. ÖzdemirM. AtayM.H. Acute serious thrombocytopenia associated with intracoronary tirofiban use for primary angioplasty.Case Rep. Med.201420141310.1155/2014/19014924715904
     [Google Scholar]
  4. MittaA. CurtisB.R. ReeseJ.A. GeorgeJ.N. Drug-induced thrombocytopenia: 2019 Update of clinical and laboratory data.Am. J. Hematol.2019943E76E7830549322
     [Google Scholar]
  5. GauerR.L. BraunM.M. Thrombocytopenia.Am. Fam. Physician201285661262222534274
     [Google Scholar]
  6. PoullisM. MalikI. Thrombocytopenia and glycoprotein IIb/IIIa inhibitors: causation or association?Circulation200010125E24110.1161/01.CIR.101.25.e24110869280
     [Google Scholar]
  7. WesslerJ.D. GiuglianoR.P. Risk of thrombocytopenia with glycoprotein IIb/IIIa inhibitors across drugs and patient populations: a meta-analysis of 29 large placebo-controlled randomized trials.Eur. Heart J. Cardiovasc. Pharmacother.2015129710610.1093/ehjcvp/pvu00827533978
     [Google Scholar]
  8. SaidS.M. HahnJ. SchleyerE. MüllerM. FiedlerG.M. BuerkeM. ProndzinskyR. Glycoprotein IIb/IIIa inhibitor-induced thrombocytopenia.Clin. Res. Cardiol.2007962616910.1007/s00392‑006‑0459‑717146606
     [Google Scholar]
  9. CurtisB.R. DivgiA. GarrittyM. AsterR.H. Delayed thrombocytopenia after treatment with abciximab: a distinct clinical entity associated with the immune response to the drug.J. Thromb. Haemost.20042698599210.1111/j.1538‑7836.2004.00744.x15140135
     [Google Scholar]
  10. VisentinG.P. LiuC.Y. Drug-induced thrombocytopenia.Hematol. Oncol. Clin. North Am.2007214685696, vi10.1016/j.hoc.2007.06.00517666285
     [Google Scholar]
  11. TopolEJ MoliternoDJ HerrmannHC PowersER GrinesCL CohenDJ CohenEA BertrandM NeumannFJ StoneGW DiBattistePM DemopoulosL Do Tirofiban and ReoPro Give Similar Efficacy Trial. Comparison of two platelet glycoprotein IIb/IIIa inhibitors, tirofiban and abciximab, for the prevention of ischemic events with percutaneous coronary revascularization.N Engl J Med.20013442518881894
     [Google Scholar]
  12. MerliniP.A. RossiM. MenozziA. BurattiS. BrennanD.M. MoliternoD.J. TopolE.J. ArdissinoD. Thrombocytopenia caused by abciximab or tirofiban and its association with clinical outcome in patients undergoing coronary stenting.Circulation2004109182203220610.1161/01.CIR.0000127867.41621.8515117843
     [Google Scholar]
  13. ChristenJ.R. SoubrierC. MartinezE. RoumieuV. DarmonO. ScandaliarisS. PicouL. CuissetT. GradosA. BernitE. EbboM. HarléJ.R. SchleinitzN. Long-lasting thrombocytopenia induced by glycoprotein IIb/IIIa inhibitor.Rev. Med. Interne2017381176977310.1016/j.revmed.2017.05.01328690092
     [Google Scholar]
  14. KuterD.J. The biology of thrombopoietin and thrombopoietin receptor agonists.Int. J. Hematol.2013981102310.1007/s12185‑013‑1382‑023821332
     [Google Scholar]
  15. AsterR.H. Immune thrombocytopenia caused by glycoprotein IIb/IIIa inhibitors.Chest20051272Suppl.53S59S10.1378/chest.127.2_suppl.53S15706031
     [Google Scholar]
  16. SahuK.K. JindalV. AndersonJ. SiddiquiA.D. JaiyesimiI.A. Current perspectives on diagnostic assays and Anti-PF4 antibodies for the diagnosis of heparin-induced thrombocytopenia.J. Blood Med.20201126727710.2147/JBM.S23264832884385
     [Google Scholar]
  17. AlexanderK.P. PetersonE.D. Minimizing the risks of anticoagulants and platelet inhibitors.Circulation2010121171960197010.1161/CIRCULATIONAHA.109.85313520439812
     [Google Scholar]
  18. VelibeyY. GolcukY. EkmekciA. AltayS. GunayE. ErenM. Tirofiban-induced acute profound thrombocytopenia: What is the optimal approach to treatment?Platelets201526219719810.3109/09537104.2013.78740623786335
     [Google Scholar]
  19. BakchoulT. MariniI. Drug-associated thrombocytopenia.Hematology (Am. Soc. Hematol. Educ. Program)20182018157658310.1182/asheducation‑2018.1.57630504360
     [Google Scholar]
  20. TekeH.Ü. TekeD. Profound thrombocytopenia related with tirofiban: Will it be enough to only stop medicine?Platelets201324433533710.3109/09537104.2012.69674922720791
     [Google Scholar]
  21. SaidS.M. HahnJ. SchleyerE. MüllerM. FiedlerG.M. BuerkeM. Glycoprotein IIb/IIIa inhibitor-induced thrombocytopenia: diagnosis and treatment.Clin Res Cardiol.2007962619
     [Google Scholar]
/content/journals/nemj/10.2174/04666230308141033
Loading
Acute Thrombocytopenia after Administration of Heparin and Tirofiban: Differential Diagnosis and Treatment
NEW Emirates Medical J 4, e080323214477 (2023); https://doi.org/10.2174/04666230308141033
/content/journals/nemj/10.2174/04666230308141033
/content/journals/nemj/10.2174/04666230308141033
Loading

Data & Media loading...


  • Article Type:     Case Report
Keyword(s): Heparin-induced thrombocytopenia; IIb/IIIa glycoprotein inhibitors; Myocardial infarction; Thrombocytopenia; Tirofiban; Treatment

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test