title: Delayed severe abciximab-induced thrombocytopenia: A case report.
abstract: BACKGROUND
  Thrombocytopenia is a possible side effect of routinely administered medical agents widely used in the management of patients with acute coronary syndromes (ACS). It is usually observed within 24 h after abciximab infusion. Differential diagnosis is challenging and the management controversial.
  
  
  METHODS
  We present a case of abciximab-induced thrombocytopenia which occurred after a standard treatment.
  
  
  RESULTS
  A 57-year-old male was admitted with ST-segment elevation ACS. Coronary angiography revealed an acute occlusion of the diagonal branch by massive thrombus. The patient was administered clopidogrel and acetylsalicylic acid followed by unfractionated heparin and abciximab according to the current guidelines. A rapid progression of thrombocytopenia up to 1 × 10(9)/L was observed. A total of 5 pooled platelet units were transfused and intravenous dexamethasone. Dual antiplatelet therapy was continued.
  
  
  CONCLUSIONS
  Although specific mechanisms of abciximab-related thrombocytopenia are still unclear and the management is not well established, the patient responded well to the therapy and his recovery was uneventful.
authors.affiliation: Provincial Hospital Complex in Kielce, Department of Cardiology, 45 Grunwaldzka Street, 25-715 Kielce, Poland. Electronic address: piatas22@op.pl.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Piątek
authors.affiliation: Provincial Hospital Complex in Kielce, Department of Cardiology, 45 Grunwaldzka Street, 25-715 Kielce, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Janion-Sadowska
authors.affiliation: Provincial Hospital Complex in Kielce, Department of Cardiology, 45 Grunwaldzka Street, 25-715 Kielce, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kurzawski
authors.affiliation: Provincial Hospital Complex in Kielce, Medical Laboratory, 45 Grunwaldzka Street, 25-715 Kielce, Poland; The Jan Kochanowski University (JKU) in Kielce, The Faculty of Health Science, 19 IX Wieków Kielc Street, 25-317 Kielce, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Grabowska
authors.affiliation: Provincial Hospital Complex in Kielce, Department of Cardiology, 45 Grunwaldzka Street, 25-715 Kielce, Poland; The Jan Kochanowski University (JKU) in Kielce, The Faculty of Health Science, 19 IX Wieków Kielc Street, 25-317 Kielce, Poland.
authors.forename: Marianna
authors.initials: M
authors.lastname: Janion
mesh_terms: D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D017023:Coronary Angiography; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin; D000077284:Abciximab
keywords: Abciximab; Acute coronary syndrome; Antiplatelet drugs; Bleeding; Thrombocytopenia