Author/Editor		Kozak, Matija; Dovč, Tadeja; Rožman, Primož; Blinc, Aleš
Title		A case of pseudothrombocytopenia after infusion of abciximab in vivo and anticoagulant-independent platelet clumping after rechallenge with abciximab in vitro
Type		članek
Source		Wien Klin Wochenschr
Vol. and No.		Letnik 112, št. 3
Publication year		2000
Volume		str. 138-41
Language		eng
Abstract		A 45-year old man was treated for unstable angina pectoris with percutaneous transluminal angioplasty and stenting of his left anterior descending coronary artery. The procedure was followed by infusion of abciximab. The patient's automated platelet count in an EDTA-anticoagulated blood sample at admission to the hospital was normal, but dropped to 5 x 10(9)/l three hours after the procedure. The infusion of abciximab was stopped and the patient received platelet transfusions although there were no signs of bleeding. Two days later his platelet count was still low (37 x 10(9)/l) in an EDTA-anticoagulated blood sample, but normal (193 x 10(9)/l) in a heparin-anticoagulated sample. Platelet clumps were present only in the sample anticoagulated with EDTA, and pseudothrombocytopenia was diagnosed. The patient's recovery was uneventful. At follow-up visits four months and one year after discharge from hospital, the patient's blood samples were anticoagulated with three different anticoagulants: EDTA, citrate and heparin. The platelet count was normal in all three samples but after mixing with abciximab in vitro it dropped profoundly due to platelet clumping, regardless of the choice of the anticoagulant. Our report raises two points: (a) one needs to consider the possibility of pseudothrombocytopenia in a patient with a low automated platelet count after infusion of abciximab but without signs of bleeding, and (b) the in vitro results suggest that our patient who had initially responded to abciximab with pseudothrombocytopenia could develop true thrombocytopenia after repeated exposure.
Descriptors		THROMBOCYTOPENIA PLATELET GLYCOPROTEIN GPIIB-IIIA COMPLEX PLATELET AGGREGATION INHIBITORS PLATELET AGGREGATION IMMUNOGLOBULINS, FAB MIDDLE AGE PLATELET COUNT EDETIC ACID DIAGNOSIS, DIFFERENTIAL BLOOD COAGULATION TESTS ANTICOAGULANTS ANTIBODIES, MONOCLONAL ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY ANGINA, UNSTABLE