Key result
Local infusion of abciximab for a lower-extremity thrombus caused acute profound thrombocytopenia within 2 hours, leading to a large retroperitoneal hematoma.
Case Report (n=1)
Demonstrates the critical need to monitor platelet counts within 2 to 4 hours following local abciximab administration to prevent severe bleeding complications.
May warrant early platelet monitoring after local abciximab; single case leaves incidence and generalizability open.
Glycoprotein (GP) IIb/IIIa receptor antagonists are powerful antiplatelet agents that are typically used in percutaneous coronary intervention. All three GP IIb/IIIa agents currently approved for use in the United States cause thrombocytopenia as a rare side effect. Abciximab is unique to the class in that it is a modified monoclonal antibody to the GP IIb/IIIa receptor, a property that can lead to increased platelet destruction. Presented herein is a patient who received a local infusion of abciximab for a lower-extremity thrombus and within 2 hours developed an acute profound thrombocytopenia that likely caused a large retroperitoneal hematoma. This case demonstrates the importance of checking platelet count within 2 to 4 hours after local (in addition to systemic) abciximab administration. Additionally, this report outlines how other causes of acute precipitous platelet drops, such as heparin-induced thrombocytopenia and pseudothrombocytopenia, can be rapidly excluded and allow for the prompt initiation of optimal therapy to minimize bleeding.
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Peters et al. (2012) conducted a case report in Lower-extremity thrombus (n=1). Local abciximab infusion was evaluated on Acute profound thrombocytopenia. Local infusion of abciximab for a lower-extremity thrombus caused acute profound thrombocytopenia within 2 hours, leading to a large retroperitoneal hematoma.
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