Letter to the Editor

Acute Profound Thrombocytopenia Following Eptifibatide Administration

Authors: Mohammad Tahir, MBBS, Arshad Banday, MBBS, Shahnawaj Karim, MBBS, Philip R. Sullivan, MD

Abstract

To the Editor:


An 84-year-old female with a history of diabetes mellitus, hypertension, ulcerative colitis, and dyslipidemia presented to the emergency room with acutely worsening shortness of breath (SOB). Home medications included aspirin, glimepiride, insulin, furosemide, metoprolol, mesalamine, irbesartan, simvastatin, and vitamins. Examination showed bibasilar fine crackles with 1+ pitting pedal edema. She denied history of upper gastrointestinal bleed, and stool guaiac was negative. Complete blood count (CBC) was normal except leukocytosis (15,900/mm3). Her blood urea nitrogen and creatinine were 53 and 1.6 mg/dL. Chest x-ray showed bilateral hilar infiltrates. Cardiac biomarkers were only significant for brain natriuretic peptide of 472 pg/mL. She was admitted with working diagnosis of congestive heart failure exacerbation and possible pneumonia. She was started on intravenous (IV) diuretics and antibiotics. Irbesartan and metoprolol were held. Subcutaneous heparin was started for deep vein thrombosis (DVT) prophylaxis.

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