Eptifibatide-induced acute profound thrombocytopenia presenting as refractory hypotension.
A 61-year-old woman presented with acute coronary syndrome and was given heparin and eptifibatide in conjunction with coronary angioplasty. Shortly thereafter she became profoundly thrombocytopenic (platelets 2.0 x 10(9)/L) and developed severe refractory hypotension. Heparin-induced antibodies were not detected, but the patient developed strong eptifibatide-dependent antibodies specific for platelets that appear to explain both the thrombocytopenia and the hypotensive episode.
Rezkalla
Shereif H
SH
Department of Cardiology, Marshfield Clinic, Marshfield, Wisconsin 54449, USA. rezkalls@mfldclin.edu
Hayes
John J
JJ
Curtis
Brian R
BR
Aster
Richard H
RH
D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D000077542:Eptifibatide; D005260:Female; D006801:Humans; D007022:Hypotension / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D010455:Peptides / Q000009:adverse effects* / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications* / Q000000981:diagnostic imaging; D013997:Time Factors
D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide