Practical approach to the diagnosis and management of thrombocytopenia associated with tirofiban treatment.
Anti-GPIIb/IIIa associated thrombocytopenia has been reported in most large trials, but very little data is available regarding tirofiban. We report three cases of thrombocytopenia, most likely attributed to tirofiban (two moderate and one severe). For each patient, laboratory investigation has allowed us to exclude another cause of thrombocytopenia, particularly heparin-induced thrombocytopenia. Platelet count recovery could be earlier with tirofiban than with abciximab. Some suggestions are proposed for practical management of these patients with persistent thrombotic risk, who are sometimes candidates for cardiopulmonary bypass surgery.
Hematology Laboratory, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
Agnès
A
Mulot
Frédéric
F
Moulin
Anne
A
Fohlen-Walter
Michael
M
Angioi
Mohammed
M
Sghaier
Jean-Pierre
JP
Carteaux
Thomas
T
Lecompte
Emmanuel
E
de Maistre
D000368:Aged; D019468:Disease Management; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D010976:Platelet Count; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D000077466:Tirofiban; D014443:Tyrosine / Q000009:adverse effects* / Q000031:analogs & derivatives*
D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D006493:Heparin; D000077466:Tirofiban