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Thrombocytopenia associated with c7E3 Fab (abciximab)
D A Schell1, A K Ganti, R Levitt
1Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, 1919 N Elm Street, Fargo, ND 58102, USA.
Annals of Hematology
|March 22, 2002
Summary
Abciximab can cause thrombocytopenia, but many cases are pseudothrombocytopenia due to EDTA. True thrombocytopenia is rare and generally benign, while pseudothrombocytopenia requires careful diagnosis to avoid drug discontinuation.
Area of Science:
- Cardiology
- Hematology
- Clinical Pharmacology
Background:
- Abciximab (c7E3 Fab) is used to prevent complications during percutaneous coronary intervention.
- Thrombocytopenia is a known complication of abciximab therapy.
- Pseudothrombocytopenia, caused by EDTA-activated platelet agglutination, can mimic true thrombocytopenia.
Purpose of the Study:
- To evaluate the incidence of true and pseudothrombocytopenia following abciximab infusion.
- To characterize the clinical presentation and outcomes of thrombocytopenia in patients receiving abciximab.
- To differentiate between true and pseudothrombocytopenia in this patient population.
Main Methods:
- Sixty-six patients receiving their first abciximab infusion were monitored.
- Platelet counts were assessed at multiple time points post-infusion.
- Peripheral blood smears were performed on patients with thrombocytopenia to identify pseudothrombocytopenia.
Main Results:
- 17 patients (25.6%) developed thrombocytopenia, with 9 (13.6%) experiencing acute severe thrombocytopenia.
- 18 of these patients had pseudothrombocytopenia, which occurred anytime within 24 hours.
- True thrombocytopenia onset was at 4 hours; it was generally benign with no life-threatening hemorrhage.
Conclusions:
- Acute severe thrombocytopenia is a relatively benign adverse effect of abciximab.
- Pseudothrombocytopenia is increasingly recognized in patients receiving abciximab.
- Peripheral blood smear examination or using heparin tubes for platelet counts can help exclude pseudothrombocytopenia, preventing unnecessary drug discontinuation.
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