Abciximab and fatal pulmonary hemorrhage.
Abciximab, a platelet glycoprotein IIb/IIIa receptor blocker, is a well-known agent in percutaneous coronary intervention because of its antiplatelet, antithrombotic effects, which allow for good outcome. Major bleeding is a well-recognized complication of abciximab therapy, and pulmonary hemorrhage, although infrequent, is a serious, under-recognized, and often fatal complication. We describe a case of fatal pulmonary hemorrhage in a young woman who presented with acute myocardial infarction and cardiogenic shock and was treated with abciximab in conjunction with percutaneous coronary intervention. The possibility of diffuse pulmonary hemorrhage should be strongly suspected in the presence of hypoxemia, infiltrates on chest radiography, and a decrease in hemoglobin. Awareness about this complication of abciximab therapy on the part of physicians and health care professionals is strongly warranted. Therapy that may be used if diagnosis is promptly made includes bronchoscopic-guided balloon tamponade or iced saline lavage. These therapeutic interventions are still in the developmental stage, and to date there are no trials to document their efficacy and survival benefit.
Usman
M Haris U
MH
Department of Internal Medicine, Drexel University College of Medicine, Darby, Pennsylvania, USA.
Shah
Manzoor A
MA
ul-Islam
Tasbir
T
Adenwalla
Humaira N
HN
Rahman
Fahd
F
Baqir
Misbah
M
Altaf
Mujeeb
M
Venkataraman
Rajesh
R
Cherayil
Marina
M
Berger
Stanley
S
D000077284:Abciximab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006469:Hemoptysis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007262:Infusions, Intravenous; D009203:Myocardial Infarction / Q000188:drug therapy / Q000503:physiopathology; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D013902:Radiography, Thoracic
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077284:Abciximab