Diagnosis and treatment recommendations and case study of severe thrombocytopenia caused by tirofiban
Journal Title: Chinese Journal of Blood Transfusion - Year 2023, Vol 36, Issue 7
Abstract
Objective To investigate the clinical manifestations, diagnosis, differential diagnosis and management strategies of thrombocytopenia caused by tirofiban. Methods The basic clinical data, platelet count changes and treatment course of 7 patients with acute coronary syndrome who used tirofiban resulting in severe thrombocytopenia during their hospitalization in our hospital from December 2021 to March 2023 were collected, and their individual and common characteristics were analyzed. Results Platelet counts were in the normal range in all 7 patients on admission. Six of the patients had thrombocytopenia occurring from 3 to 16 hours after tirofiban use, and one patient was detected at 34 h of tirofiban use. Their minimum platelet count ranged from (1-11)×109/L. All 7 cases discontinued tirofiban and other antithrombotic drugs, and the platelet count increased to 50×109/L in 6 patients in 2 to 4 days after stopping the drug and gradually returned to the normal range. During this period, there were no bleeding or acute thrombotic events, and no platelet transfusion was conducted. Five patients resumed antithrombotic therapy when the platelet count returned to (20-50)×109/L, 1 patient underwent elective coronary artery bypass grafting (CABG) surgery when the count rose above 50×109/L. One patient had bleeding manifestations after thrombocytopenia and required limited-duration CABG surgery, so 3 U platelet transfusion and immunoglobulin treatment were performed consecutively. CABG surgery was performed when the platelet count increased to 76×109/L. The differential diagnosis of the cause of thrombocytopenia was performed in all seven patients, and other causes of thrombocytopenia, such as heparin, were excluded. Conclusion Tirofiban can cause acute severe or extremely severe thrombocytopenia. Routine platelet count testing at 6 hours after medication can prevent serious adverse events by discontinuing tirofiban promptly after thrombocytopenia occurs. At the same time, it is determined whether to perform platelet transfusion based on whether the patient has bleeding and the risk of bleeding, and the timing of resuming antithrombotic treatment is determined based on the recovery of platelet count and the risk of thrombosis.
Authors and Affiliations
Xiaohui LIU, Cuihua TAO
Keywords
Related Articles
- EP ID EP738593
- DOI 10.13303/j.cjbt.issn.1004-549x.2023.07.014
- Views 46
- Downloads 0
Secondary herpes zoster wound cured by allogeneic platelet-rich plasma: a case report
Objective To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of herpes zoster wounds secondary to systemic lupus erythematosus (SLE), especially large ulcer wounds. Methods The trea...
Establishment of Shaanxi rare blood group information supply platform
Objective To establish a rare blood group information supply platform in Shaanxi Province. Methods The rare blood group information supply platform consists of sample registration, result registration, donor files and in...
Predictive value of preoperative liver function for perioperative massive blood transfusion in patients undergoing ascending aorta surgery
Objective To explore the predictive value of preoperative liver function for massive blood transfusion (MBT) in patients undergoing ascending aorta surgery. Methods Data from 238 patients undergoing ascending aorta surge...
Effect of long-term frozen plasma on the detection of HBsAg by ELISA
Objective To evaluate the HBsAg detection results of HBsAg+ samples after 8 years refrigeration by ELISA and evaluate the effectiveness of the current storage policy of retained samples. Methods A total of 100 HBsAg+ pla...
Impact of blood screening strategies for Hepatitis C virus on blood safety
Objective To establish a reasonable and effective blood screening strategy for Hepatitis C virus (HCV), so as to reduce the risk of blood transfusion transmission, ensure blood safety and improve the quality of blood scr...