Tirofiban-Induced Severe Thrombocytopenia Post-Drug Eluting Balloon Coronary Intervention: A Case Report

Abstract

Background: Glycoprotein IIb/IIIa inhibitors have been reported to cause thrombocytopenia, however, only few case reports exist regarding tirofiban. We report a rare case of tirofiban-induced severe thrombocytopenia and its management. 

Case Presentation: We present a 51-year-old male who underwent coronary angioplasty with drug eluting balloon for exertional angina. The platelet count dropped from 230 x 109/L (before angiogram) to 3.8 x 109/L within 24 hours of intravenous tirofiban infusion without active bleeding. We transfused 4 units of platelets, continued aspirin and clopidogrel and monitored in coronary care unit. Gradually the platelet count improved with no evidence of bleeding, ischemic or thrombotic events. 

Conclusion: The case highlights the awareness for the dramatic and profound tirofiban-induced thrombocytopenia that may pose a challenge to manage.