Acute profound thrombocytopenia secondary to local abciximab infusion.
Glycoprotein (GP) IIb/IIIa receptor antagonists are powerful antiplatelet agents that are typically used in percutaneous coronary intervention. All three GP IIb/IIIa agents currently approved for use in the United States cause thrombocytopenia as a rare side effect. Abciximab is unique to the class in that it is a modified monoclonal antibody to the GP IIb/IIIa receptor, a property that can lead to increased platelet destruction. Presented herein is a patient who received a local infusion of abciximab for a lower-extremity thrombus and within 2 hours developed an acute profound thrombocytopenia that likely caused a large retroperitoneal hematoma. This case demonstrates the importance of checking platelet count within 2 to 4 hours after local (in addition to systemic) abciximab administration. Additionally, this report outlines how other causes of acute precipitous platelet drops, such as heparin-induced thrombocytopenia and pseudothrombocytopenia, can be rapidly excluded and allow for the prompt initiation of optimal therapy to minimize bleeding.
Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana.
Matthew N
MN
Peters
Christopher D
CD
Press
John C
JC
Moscona
Rashad H Khazi
RH
Syed
Morgan J
MJ
Katz
Alison A
AA
Egan
Mohannad B
MB
Bisharat
Vikram S
VS
Nijjar
Asif H
AH
Anwar