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Case report| Volume 27, ISSUE 6, P869.e13-869.e14, November 2011

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Delayed Immune-Mediated Thrombocytopenia After Re-exposure to Abciximab Therapy

Published:September 02, 2011DOI:https://doi.org/10.1016/j.cjca.2011.05.011

      Abstract

      Abciximab is a potent antiplatelet agent that is increasingly being used to prevent ischemic complications of percutaneous coronary revascularization. Thrombocytopenia, including acute profound thrombocytopenia, has been reported to occur with this agent, but usually within 1 to 2 days of exposure. We report the case of a woman aged 68 years who presented with profound delayed thrombocytopenia 9 days after a second exposure to abciximab. She was treated successfully with intravenous immunoglobulin with complete resolution of the thrombocytopenia and no subsequent recurrences.

      Résumé

      L'abciximab est un agent antiplaquettaire puissant qui est de plus en plus utilisé pour prévenir les complications ischémiques de la revascularisation coronarienne percutanée. La thrombocytopénie, incluant la thrombocytopénie profonde aiguë, a été rapportée avec cet agent, mais habituellement après 1 à 2 jours d'exposition. Nous rapportons le cas d'une femme âgée de 68 ans qui a présenté une thrombocytopénie retardée profonde 9 jours après une deuxième exposition à l'abciximab. Elle a été traitée avec succès par immunoglobulines intraveineuses avec résolution complète de la thrombocytopénie et aucune récurrence subséquente.
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      References

        • Berkowitz S.D.
        • Sane D.C.
        • Sigmon K.N.
        • et al.
        Occurrence and clinical significance of thrombocytopenia in a population undergoing high-risk percutaneous coronary revascularization: Evaluation of c7E3 for the Prevention of Ischemic Complications (EPIC) study group.
        J Am Coll Cardiol. 1998; 32: 311-319
        • Lo G.K.
        • Juhl D.
        • Warkentin T.E.
        • et al.
        Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings.
        J Thromb Haemost. 2006; 4: 759-765
        • Curtis B.R.
        • Divgi A.
        • Garritty M.
        • et al.
        Delayed thrombocytopenia after treatment with abciximab: a distinct clinical entity associated with the immune response to the drug.
        J Thromb Haemost. 2004; 2: 985-992
        • Tcheng J.E.
        • Kereiakes D.J.
        • Lincoff A.M.
        • et al.
        Abciximab readministration: results of the ReoPro Readministration Registry.
        Circulation. 2001; 104: 870-875
        • Von Drygalski A.
        • Curtis B.R.
        • Bougie D.W.
        • et al.
        Vancomycin-induced immune thrombocytopenia.
        N Engl J Med. 2007; 356: 904-910