Severe Thrombocytopenia Associated with Low dose of Intracoronary Tirofiban

Yıl 2026, Cilt: 17 Sayı: 1 , 41 - 43 , 31.03.2026

Vahit Demir , Yasar Turan , Elif Turan

https://doi.org/10.33706/jemcr.1854256

https://izlik.org/JA34ZF85GD

Öz

Tirofiban is a glycoprotein IIb/IIIa inhibitor and is an adjunct in the treatment of patients with acute coronary syndrome. Its main side effects are bleeding and thrombocytopenia. Severe thrombocytopenia is a rare but serious complication of tirofiban therapy, including when administered at low intracoronary doses in interventional cardiac procedures. The pathogenesis is largely immune-mediated and can result in abrupt and profound platelet count declines. Early and frequent platelet monitoring, prompt discontinuation of the drug, and supportive care remain critical to managing this adverse effect. In this case report, we present a case of severe thrombocytopenia that occurred in a 74-year-old male patient with non-ST segment elevation myocardial infarction following administration of a very low dose of tirofiban.

Anahtar Kelimeler

case report , platelets , thrombocytopenia , tirofiban

Etik Beyan

Informed consent was obtained from the patient for publication of this case report and images.

Destekleyen Kurum

There is no specific funding related to this case report.

Düşük doz İntrakoroner Tirofiban Tedavisi Sonrası Gelişen Şiddetli Trombositopeni

https://izlik.org/JA34ZF85GD

Öz

Tirofiban, glikoprotein IIb/IIIa inhibitörüdür. Akut koroner sendromlu hastaların tedavisinde yardımcı bir ilaçtır. Başlıca yan etkileri kanama ve trombositopenidir. Şiddetli trombositopeni, tirofiban tedavisinin nadir ancak ciddi bir komplikasyonudur. Bu durum girişimsel kardiyak işlemlerde düşük intrakoroner dozlarda uygulandığında bile ortaya çıkabilir. Patogenezi büyük ölçüde immün aracılıdır. Trombosit sayısında ani ve şiddetli düşüşlere neden olabilir. Bu yan etkinin yönetimi için erken ve sık trombosit takibi, ilacın derhal kesilmesi ve destekleyici bakım kritik önem taşımaktadır. Bu vaka raporunda, ST segment yükselmesiz miyokard enfarktüsü olan 74 yaşında bir erkek hastada çok düşük dozda tirofiban uygulamasının ardından ortaya çıkan şiddetli trombositopeni vakasını sunuyoruz.

Anahtar Kelimeler

olgu sunumu , platelet , trombositopeni , tirofiban

Etik Beyan

Bu vaka raporunun ve görsellerin yayınlanması için hastadan onay alınmıştır.

Destekleyen Kurum

Bu vaka raporuyla ilgili bir finansman söz konusu değildir.

Kaynakça

• Wang J, Zou D. Tirofiban-induced thrombocytopenia. Ann Med. 2023;55(1):2233425.
• Sousou JM, Ali K, O’Brien MC, Williams JM, Kandah F, Franchi F. Severe tirofiban-induced thrombocytopenia following percutaneous coronary intervention. J Cardiol Cases. 2025; 2;32(1):47-50.
• Bougie DW, Wilker PR, Wuitschick ED, Curtis BR, Malik M, Levine S, et al. Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa. Blood. 2002;15;100(6):2071-6.
• Lardinois B, Favresse J, Chatelain B, Lippi G, Mullier F. Pseudothrombocytopenia-A review on causes, occurrence and clinical implications. J Clin Med. 2021;10:594.
• Li Y, Qiu J, Gao Y, Li G. Case report: reuse of tirofiban leads to very severe thrombocytopenia. Front Cardiovasc Med. 2023;19;10:1130552.
• Aster RH, Curtis BR, Bougie DW, Dunkley S, Greinacher A, Warkentin TE, et al. Thrombocytopenia associated with the use of GPIIb/IIIa inhibitors: position paper of the ISTH working group on thrombocytopenia and GPIIb/IIIa inhibitors. J Thromb Haemost. 2006;4:678–9.
• Yurtdaş M, Yaylali YT, Aladağ N, Ozdemir M, Atay MH. Acute serious thrombocytopenia associated with intracoronary tirofiban use for primary angioplasty. Case Rep Med. 2014;2014:190149.