ABSTRACT
A 62-year-old white male experienced thrombocytopenia six days after receiving abciximab following (bolus: 0.25 mg/kg followed by 10 mg/min infusion for 12 hours) percutaneous transluminal coronary angioplasty (PTCA) for the treatment of an acute anterior myocardial infarction. Due to a history of intravenous dye allergy, the patient was medicated with diphenhydramine and methylprednisolone (125 mg) prior to coronary angiography which re vealed complete occlusion of the left anterior descending coronary artery. Other post PTCA medications included heparin, warfarin, captopril, metoprolol, aspirin, and insulin. The platelet count remained stable (175 to 180 x 103/ mL) until dropping to 7 x 103/mL six days post abciximab administration. Peripheral blood smear and serum creatinine (0.8 mg/dL) were normal. Meto prolol and captopril were held. Disseminated intravascular coagulation panel and heparin-dependent platelet antibody with platelet aggregation and study were negative. After intravenous immunoglobulin (1 g/kg) and platelets (one unit) were administered, the platelet count immediately increased (34 x 103mL) with a steady progression noted on discharge (201 x 103/mL).
