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.
Subject(s)
Platelet Aggregation Inhibitors/adverse effects , Thrombocytopenia/chemically induced , Tyrosine/analogs & derivatives , Aged , Humans , Male , Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors , Severity of Illness Index , Thrombocytopenia/pathology , Time Factors , Tirofiban , Tyrosine/adverse effectsABSTRACT
As a rural private practice in occupational therapy expanded to meet the service requests in a large, sparsely populated area, the need for fast, efficient transportation became obvious. A private pilot's license was acquired and then an airplane was purchased to meet that transportation need. The private practice, geographical area and the intervention methods are reviewed. The efficiency, cost, safety and practicality of flying, and its effect on the success of the private practice are then described.
