Loading...
Please wait, while we are loading the content...
Similar Documents
Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa
| Content Provider | Scilit |
|---|---|
| Author | Bougie, Daniel W. Wilker, Peter R. Wuitschick, Elizabeth D. Curtis, Brian R. Malik, Mohammad Levine, Stewart Lind, Richard N. Pereira, Jaime Aster, Richard H. |
| Copyright Year | 2002 |
| Description | Acute thrombocytopenia is a recognized complication of treatment with GPIIb/IIIa inhibitors whose cause is not yet known. We studied 9 patients who developed severe thrombocytopenia (platelets less than 25 × 109/L) within several hours of treatment with the GPIIb/IIIa inhibitors tirofiban (4 patients) and eptifibatide (5 patients). In each patient, acute-phase serum contained a high titer (range, 1:80-1:20 000) IgG antibody that reacted with the glycoprotein IIb/IIIa complex only in the presence of the drug used in treatment. Four patients had been previously treated with the same drug, but 5 had no known prior exposure. Pretreatment serum samples from 2 of the latter patients contained drug-dependent antibodies similar to those identified after treatment. No tirofiban- or eptifibatide-dependent antibodies were found in any of 100 randomly selected healthy blood donors, and only 2 of 23 patients receiving tirofiban or eptifibatide who did not experience significant thrombocytopenia had extremely weak (titer, 1:2) tirofiban-dependent antibodies. In preliminary studies, evidence was obtained that the 9 antibodies recognize multiple target epitopes on GPIIb/IIIa complexed with the inhibitor to which the patient was sensitive, indicating that they cannot all be specific for the drug-binding site. The findings indicate that acute thrombocytopenia after the administration of tirofiban or eptifibatide can be caused by drug-dependent antibodies that are “naturally occurring” or are induced by prior exposure to drug. These antibodies may be human analogs of mouse monoclonal antibodies that recognize ligand-induced binding sites (LIBS) induced in the GPIIb/IIIa heterodimer when it reacts with a ligand-mimetic drug. |
| Related Links | https://ashpublications.org/blood/article-pdf/100/6/2071/42761/h81802002071.pdf |
| Ending Page | 2076 |
| Page Count | 6 |
| Starting Page | 2071 |
| DOI | 10.1182/blood.v100.6.2071.h81802002071_2071_2076 |
| Journal | Blood |
| Issue Number | 6 |
| Volume Number | 100 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 2002-09-15 |
| Access Restriction | Open |
| Subject Keyword | Hematology Treatment Antibodies Acute Tirofiban Eptifibatide Gpiib/iiia Prior Exposure Drug Dependent Reacts Journal: Blood (Vol- 90, Issue- 6) |
| Content Type | Text |
| Resource Type | Article |
