Gulati Amit, Tiwari Aparna, Shetty Vijay, Nwosu Ifeanyi, Khurana Sakshi
Internal Medicine, Maimonides Medical Center, Brooklyn, USA.
Radiology, New York Presbyterian-Columbia University Irving Medical Center, New York City, USA.
Cureus. 2021 Sep 23;13(9):e18217. doi: 10.7759/cureus.18217. eCollection 2021 Sep.
Patients admitted to the hospital can develop thrombocytopenia due to multifactorial causes. It can be pseudo-thrombocytopenia or true thrombocytopenia. Among patients admitted for chest pain, coronary angiography (CAG) is a common diagnostic test to evaluate patients for coronary artery disease (CAD). Normally, patients undergoing angiogram receive antiplatelets and anticoagulants pre-catheterization, and platelet aggregation inhibitor agents are sometimes used during and after CAG like in patients with high thrombus burden. Glycoprotein IIb/IIIa receptor inhibitors are a type of platelet antiaggregant agents that can cause severe thrombocytopenia in few cases. We present a case of a 68-year-old patient who came to the emergency department with inferior wall ST-segment elevation myocardial infarction and underwent angiography and had percutaneous coronary intervention (PCI) done. He was administered tirofiban during the angiogram that caused acute severe thrombocytopenia decreasing platelets count to 4000/microliter within one day. Patients' platelets gradually recovered after platelets transfusion.
入院患者可能由于多种因素而发生血小板减少症。它可以是假性血小板减少症或真性血小板减少症。在因胸痛入院的患者中，冠状动脉造影（CAG）是评估患者是否患有冠状动脉疾病（CAD）的常用诊断测试。通常，接受血管造影的患者在导管插入术前会接受抗血小板和抗凝剂治疗，对于血栓负荷高的患者，在CAG期间和之后有时会使用血小板聚集抑制剂。糖蛋白IIb/IIIa受体抑制剂是一种血小板抗聚集剂，少数情况下可导致严重的血小板减少症。我们报告一例68岁患者，因下壁ST段抬高型心肌梗死来到急诊科，接受了血管造影并进行了经皮冠状动脉介入治疗（PCI）。他在血管造影期间接受了替罗非班治疗，导致急性严重血小板减少症，血小板计数在一天内降至4000/微升。输血后患者的血小板逐渐恢复。
