[Long-lasting thrombocytopenia induced by glycoprotein IIb/IIIa inhibitor]

Rev Med Interne. 2017 Nov;38(11):769-773. doi: 10.1016/j.revmed.2017.05.013. Epub 2017 Jul 6.
[Article in French]

Abstract

Introduction: Glycoprotein IIb/IIIa inhibitors (anti-GPIIbIIIa) prevent platelet binding to fibrinogen. Transient sometimes-severe thrombocytopenia is a well-known side effect.

Observation: A 71-year-old patient presented severe thrombocytopenia after the administration of tirofiban (anti-GPIIbIIIa). Corticosteroid treatment was initiated at day 10 because of persistence of severe thrombocytopenia with poor platelet transfusion efficacy. Corticosteroid treatment led to platelet recovery evoking an immune mediated mechanism for thrombocytopenia.

Conclusion: Anti-GPIIbIIIa are associated with a risk of dramatic thrombocytopenia. The underlying mechanism is poorly understood. The management of these usually transient thrombocytopenias is based on platelet transfusion. As report here, in some cases persistent thrombocytopenia can respond to corticosteroids.

Keywords: Abciximab; Eptifibatide; Roxifiban; Thrombocytopenia; Thrombopénie; Tirofiban; anti-GPIIbIIIa.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Humans
  • Male
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
  • Severity of Illness Index
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / pathology
  • Time Factors
  • Tirofiban
  • Tyrosine / adverse effects
  • Tyrosine / analogs & derivatives*

Substances

  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Tyrosine
  • Tirofiban