Acute profound thrombocytopenia following angioplasty: the dilemma in the management and a review of the literature.
Abciximab, heparin, and clopidogrel are often used together in the setting of coronary syndromes. These drugs are associated with thrombocytopenia and it is important to quickly discriminate the cause of this complication as it has implications for the management of thrombocytopenia and the coronary syndrome. This case highlights some of the dilemmas that may arise as no test can definitively identify the offending drug, and stopping these drugs can affect the outcome of the coronary event including stent thrombosis.
Makoni
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SN
Department of Internal Medicine, Mercy Fitzgerald Hospital, 1500 Lansdowne Avenue, Darby, Pennsylvania 19023, USA. sncmakoni@hotmail.com
D000077284:Abciximab; D000208:Acute Disease; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000925:Anticoagulants / Q000009:adverse effects*; D002404:Catheterization; D000077144:Clopidogrel; D023903:Coronary Restenosis / Q000628:therapy; D003937:Diagnosis, Differential; D004338:Drug Combinations; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D015607:Stents; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis; D013988:Ticlopidine / Q000009:adverse effects* / Q000031:analogs & derivatives*
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D004338:Drug Combinations; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D000077284:Abciximab