Reactions 1680, p322 - 2 Dec 2017
A 71-year-old man developed severe thrombocytopenia
following administration of tirofiban [route, dosage and time to
reaction onset not stated].
The man was diagnosed with an acute coronary syndrome
with elevated ST-segment. His relevant medical history
included myocardial infarction, hypertension, dyslipidaemia
and weaned smoking. He was taking aspirin along with various
drugs. He received tirofiban during coronary angiography. He
also underwent a stent implantation on the anterior
interventricular artery. He was started on precautionary
anticoagulation with fondaparinux and combined anti-platelet
aggregation with prasugrel and aspirin. On the following day,
laboratory investigations showed thrombocytopenia with
thrombocyte count of 27 G/L. On day 3, thrombocyte count
was decreased to 9 G/L.
The man was treated with platelet concentrate unit (PCU)
transfusions. On request of the cardiologist, aspirin treatment
was also maintained. He was given clopidogrel only when the
platelet count elevated beyond 50 G/L. The platelet count
decreased again to 7 G/L. On day 10, there was presence of the
haemorrhagic mucosal signs. Therefore, he was seen by an
internist. Other investigations were found to be negative.
Eventually, he was started on prednisone. On day 2 from the
start of prednisone, the platelets value was found to be
>50 G/L. A tapering of prednisone dose after more than
10 days of treatment showed corticodependence led to
increase of dosage, which showed a favourable response. The
dose of prednisone was reduced again from day 31 and
stopped on day 40 without relapse of thrombocytopenia.
Author comment: "We report here the unusual case of a
patient with prolonged thrombocytopenia secondary to
tirofiban administration during coronary angiography." "We
report a case of severe thrombocytopenia secondary to the
administration of tirofiban."
Christen J-R, et al. Long-lasting thrombocytopenia induced by glycoprotein IIb/IIIa
inhibitor. Revue de Medecine Interne 38: 769-773, No. 11, Nov 2017. Available
from: URL: http://doi.org/10.1016/j.revmed.2017.05.013 [French; summarised from
a translation] - France
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved