Eptifibatide induced acute thrombocytopenia. Case report of 80- years old man with acute coronary syndrome

• Authors: Kuźma, Ł , Pogorzelski, S , Wróblewski, D , Struniawski, K , Róg-Makal, M , Nowak, K , Matys, U , Gajewska-Bachórzewska, H , Dobrzycki, S

Abstracts

EN

Introduction: Glycoprotein (Gp) IIb/IIIa is a platelet receptor participating in platelet aggregation. According to ESC guidelines, glycoprotein IIb/IIIa inhibitors might be considered during percutaneous coronary interventions in patients with the acute coronary syndrome. Purpose: A case study of profound thrombocytopenia in 80-year-old man with the acute coronary syndrome. Case presentation: An 80-year-old, medicationnaive man with acute coronary syndrome was admitted to the Department of Invasive Cardiology. Due to the unsuccessful invasive strategy, an intracoronary bolus of Gp IIb/IIIa inhibitor – eptifibatide - was administered. During the following intravenous infusion, large subcutaneous hematomas were observed. Eptifibatide infusion was discontinued. Drop in platelet count to 1 thou/μL without significant anemia was registered. A control sample in sodium citrate showed similarly low platelet count - 2 thou/uL. Acetylsalicylic acid and clopidogrel were discontinued, steroids were introduced. Neither PLT nor FFP transfusion were necessary. Consecutive lab tests showed the gradual increase of PLT up to 35 thou/μL at discharge. A week later, the patient did not complain of any cardiovascular or bleeding symptoms; hematomas resented significant involution. Laboratory findings were normal. During follow-up visit 30 days after the discharge, the patient presented no cardiovascular symptoms. Conclusions: There are patients at risk of druginduced thrombocytopenia, especially those with impaired kidney function and the elderly. In such cases, decisions concerning anti-platelet and antithrombotic therapy should be taken cautiously. Because of its rare occurrence, every case of severe thrombocytopenia in ACS patients should be reported. Moreover, such patients should be followed-up to minimalize risk of similar adverse events in the future.

Keywords

EN

Thrombocytopenia; glycoprotein IIb/ IIIa inhibitors; acute coronary syndrome

• Publisher: Uniwersytet Medyczny w Białymstoku
• Journal: Progress in Health Sciences
• Year: 2018
• Volume: 8(2)
• Pages: 234-238

Dates

published

2019-01-07

Contributors

author

Kuźma, Ł

author

Pogorzelski, S

author

Wróblewski, D

author

Struniawski, K

author

Róg-Makal, M

author

Nowak, K

author

Matys, U

author

Gajewska-Bachórzewska, H

author

Dobrzycki, S

Identifiers

DOI

10.5604/01.3001.0012.8353