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(Chest. 2005;127:53S-59S.)
© 2005 American College of Chest Physicians

Immune Thrombocytopenia Caused by Glycoprotein IIb/IIIa Inhibitors*

Richard H. Aster, MD

* From the Blood Research Institute, The Blood Center of Southeastern Wisconsin, Milwaukee, WI.

Correspondence to: Richard H. Aster, MD, Blood Research Institute, The Blood Center of Southeastern Wisconsin, PO Box 2178, Milwaukee, WI 53201-2178; e-mail: rhaster{at}bcsew.edu

Agents that react with the platelet glycoprotein (GP) IIb/IIIa complex ({alpha}IIb/ß3 integrin) to block fibrinogen binding and platelet-platelet aggregation have been proved to be effective in reducing the incidence of complications following coronary angioplasty and are now widely used for this purpose. Acute thrombocytopenia, which is sometimes severe and life-threatening, is a recognized side effect of this class of drugs. In contrast to other types of drug-induced thrombocytopenia, this complication can occur within a few hours of a patient’s first exposure to the medication. Accumulating evidence has indicated that drug-dependent antibodies, which can be naturally occurring, are the cause of platelet destruction in such individuals. In this review, we will consider the clinical aspects of thrombocytopenia resulting from sensitivity to GPIIb/IIIa inhibitors and will review evidence that the platelet destruction is antibody-mediated.

Key Words: abciximab • eptifibatide • glycoprotein IIb/IIIa inhibitors • thrombocytopenia • tirofiban






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