Abciximab-induced thrombocytopenia: management of bleeding in the setting of recent coronary stents.
This case report and subsequent literature review describes the management difficulties in a patient who developed abciximab-induced thrombocytopenia and gastrointestinal bleeding. Abciximab was used to treat the no-reflow phenomenon, which occurred during insertion of three sequential Taxus coronary artery stents. Resuscitation of this bleeding patient with fluids, blood, and platelet transfusion, and the cessation of antiplatelet agents, was complicated by acute stent thrombosis. We discuss the risk factors for stent thrombosis and discuss abciximab-induced thrombocytopenia, looking at its incidence, pathophysiology, differential diagnosis, investigation, course, management, preventative strategies, and prognostic implications.
Nowakowski
Kris
K
Departments of Cardiology, Gosford and Royal North Shore Hospitals, New South Wales, Australia.
Rogers
James
J
Nelson
Gregory
G
Gunalingam
Brendan
B
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D005440:Fluid Therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D017713:Platelet Transfusion; D012307:Risk Factors; D015607:Stents; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000628:therapy; D013927:Thrombosis
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab