Tirofiban Induced Thrombocytopenia: A Rare but Severe Adverse Effect

Area of Science:

• Cardiology
• Pharmacology
• Hematology

Background:

• Coronary angiography is a standard procedure for diagnosing coronary artery disease.
• Patients typically receive antiplatelet and anticoagulant medications during angiography.
• Glycoprotein IIb/IIIa receptor inhibitors are potent antiplatelet agents used in this setting.

Observation:

• A 69-year-old female presented with chest pain and underwent coronary angiography with stent placement.
• Tirofiban, a glycoprotein IIb/IIIa inhibitor, was administered during the procedure.
• The patient developed acute, severe thrombocytopenia, with platelet count dropping from 224,000 to 2,000/mm³ within 24 hours.

Findings:

• Tirofiban administration was associated with a precipitous decline in platelet count.
• The patient's platelet count gradually recovered following treatment with corticosteroids and platelet transfusion.
• Subsequent administration of aspirin and clopidogrel was tolerated without further decrease in platelet count.

Implications:

• This case highlights a rare but serious adverse effect of glycoprotein IIb/IIIa inhibitors.
• Prompt recognition and management are crucial for patients experiencing drug-induced thrombocytopenia.
• Careful consideration of medication resumption is necessary after recovery from thrombocytopenia.