Profound delayed thrombocytopenia presenting 16 days after Abciximab (Reopro®) administration

Area of Science:

• Cardiology
• Pharmacology
• Hematology

Background:

• Abciximab is a glycoprotein IIb/IIIa inhibitor used during percutaneous coronary interventions.
• Thrombocytopenia is a known, albeit infrequent, adverse effect of Abciximab therapy.
• The onset of Abciximab-induced thrombocytopenia is typically rapid, occurring within hours to days of administration.

Observation:

• This report details a unique case of severe, life-threatening thrombocytopenia.
• The patient experienced thrombocytopenia 16 days post-Abciximab administration.
• This represents the longest documented delay in the presentation of Abciximab-induced thrombocytopenia.

Findings:

• The patient required significant supportive care, including transfusions.
• Treatment with dexamethasone and intravenous immunoglobulin led to patient improvement.
• Delayed-onset Abciximab-induced thrombocytopenia can occur and may be severe.

Implications:

• Clinicians should maintain a high index of suspicion for delayed Abciximab-induced thrombocytopenia, even weeks after administration.
• Extended monitoring may be warranted in select patients.
• This case expands the known temporal spectrum of Abciximab-associated adverse events.