RESUMO
Anti-GPIIb/IIIa associated thrombocytopenia has been reported in most large trials, but very little data is available regarding tirofiban. We report three cases of thrombocytopenia, most likely attributed to tirofiban (two moderate and one severe). For each patient, laboratory investigation has allowed us to exclude another cause of thrombocytopenia, particularly heparin-induced thrombocytopenia. Platelet count recovery could be earlier with tirofiban than with abciximab. Some suggestions are proposed for practical management of these patients with persistent thrombotic risk, who are sometimes candidates for cardiopulmonary bypass surgery.
Assuntos
Trombocitopenia/induzido quimicamente , Tirosina/análogos & derivados , Tirosina/efeitos adversos , Idoso , Gerenciamento Clínico , Feminino , Heparina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/efeitos adversos , Contagem de Plaquetas , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/antagonistas & inibidores , Trombocitopenia/diagnóstico , Trombocitopenia/tratamento farmacológico , TirofibanaRESUMO
Four cases showing different means to detect cryoglobulins are reported: effects on blood cell counts performed on 2 technologically different automated hematology instruments and microscopic features in fresh blood samples and on May-Grünwald-Giemsa-stained bloodfilms. These cases were chosen for their instructive value in depicting all artifacts associated with cryoglobulins. Laboratory recognition of the cryoglobulins is important to correct factitious results with automated blood cell counters, mainly pseudoleukocytosis and pseudothrombocytosis. Moreover cryoglobulin-induced laboratory artifacts may be the first factor prompting the assessment for cryoglobulinemia and the diagnosis of the underlying cause.
