Abstract:

Objective To explore the clinical manifestations, pathogenesis, and treatment of tirofiban-induced delayed, profound, severe thrombocytopenia. Methods Two cases of tirofiban-induced delayed, profound, severe thrombocytopenia were reported, and literature review was conducted. Results A 78-year old male patient experienced profound, severe thrombocytopenia on the 5th day of tirofiban, with a platelet count of 1×10⁹/L. The patient died of cerebral hemorrhage on the same day. Another 85-year-old female patient experienced profound, severe thrombocytopenia on the 5th day after receiving treatment with tirofiban, with a minimum platelet count of 7×10⁹/L. Platelets returned to normal on the 13th day after corticosteroids therapy and platelet transfusion. Conclusion Tirofiban-induced delayed, profound, severe thrombocytopenia is very rare, and its mechanism is still not clear. Bleeding may be the only symptom, and most of bleeding cases are mild. Severe bleeding caused by tirofiban is extremely rare. The treatment mainly includes platelet transfusion, intravenous immunoglobulin and corticosteroids.

Key words: tirofiban, thrombocytopenia