Trombocitopenia aguda profunda asociada al uso de abciximab: a propósito de un caso / Acute profound thrombocytopenia associated with the use of abciximab: case report

RESUMEN

Se presenta un paciente con angina inestable e intervención coronaria percutánea con stents, que desarrolló púrpura mucocutánea y hematoma inguinal asociados a trombocitopenia aguda profunda inducida por abciximab con nadir de 1 x 10(9)/L (1000 plaquetas/mm³), su recuperación con el tratamiento instituido y la complicación de trombosis subaguda intrastent asociada a cuenta plaquetaria funcional que requirió reintervención con angioplastía primaria y administración de tirofiban, un agente bloqueador del receptor IIb/IIIa diferente. Se realizaron estudios diagnósticos para investigar otras causas de trombocitopenia en estos pacientes que reciben heparina, antiplaquetarios como ácido acetilsalicílico y clopidogrel, asociados a bloqueadores del receptor IIb/IIIa. Se realizó una revisión de publicaciones con reporte de esta complicación.

ABSTRACT

We present the case-report of a patient with instable angina who submitted to percutaneous coronary intervention and stent place for revascularization who developed purpura and groin hematoma associated to acute profound thrombocytopenia induced by abciximab infusion with nadir platelet counts 1 x 10(9)/L (1,000 platelets/mm³), his platelet recovery with the instituted treatment and the outcome with subacute intra-stent thrombosis that was associated with functionally platelet counts that required a primary angioplasty and administration of tirofiban, a platelet glycoprotein IIb/IIIa receptor antagonist. Laboratory confirmation to exclude other causes of thrombocytopenia and its association of glycoprotein IIb/IIIa receptor antagonist with heparin, acetylsalicylic acid and clopidogrel were obtained. We perform in literature trials with this complication.