Tirofiban, a specific glycoprotein IIb/IIIa inhibitor, may cause extensive thrombocytopenia with an incidence of 0.2% to 0.5%. We report the case of a 50-year-old man who developed thrombocytopenia after tirofiban use (both intracoronary and peripheral) over hours and the successful management of this complication after primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.

ObjectiveTo investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatitis B surface antibodies (anti-HBs) in hepatitis B surface antigen (HBsAg) negative and anti-HBs positive patients with haematological malignancies or solid tumours.MethodsThis retrospective study reviewed the medical records of patients with haematological malignancies or solid tumours. Pretreatment HBsAg negative and anti-HBs positive patients were included in the analysis. Anti-hepatitis B core antibody status was used to evaluate vaccinated patients and those with resolved HBV infections.ResultsThe medical records of 237 patients were reviewed retrospectively. The median anti-HBs titre decreased significantly after anticancer therapy compared with the pretreatment median anti-HBs titre in all patients (71 mIU/ml versus 57 mIU/ml). Anti-HBs titre decreased significantly in patients with haematological malignancies (70 mIU/m versus 37 mIU/ml) and in patients administered rituximab-based chemotherapy (67 mIU/ml versus 33 mIU/ml) following chemotherapy, whereas there was no significant change in patients with solid tumours. After chemotherapy, patients with low pretreatment anti-HBs titres (<100 mIU/ml) were more likely to become seronegative (<10 mIU/ml).ConclusionHigh levels of anti-HBs may have a protective effect against the reactivation of HBV especially in patients with haematological malignancies who received immunosuppressive anticancer therapy.

Anahtar Kelimeler:Hematolojik hastalıklar Splenektomi Aşı Komplikasyon J. Exp. Clin. Med., 2012; 29:276-279 ABSTRACT Splenectomy is an important treatment option in some haematologic diseases which are aggressive and refractory to medical treatment. Splenectomy is also used for diagnosis for some of the hematologic diseases. In this study, we aimed to present the patients and the results of the diagnostic and therapeutic splenectomy due to haematologic diseases. In this study, between September 2005 and May 2011, in Ondokuz Mayıs University Faculty of Medicine, 184 patients with splenectomy were retrospectively reviewed. Fifty four patients were included who applied to Haematology Clinic and had splenectomy due to haematological diseases. 34 (63%) of patients were female and 37% (20) were male. The mean age was 43.93±16.9. The most common haematologic disease for which splenectomy was immune thrombocytopenic purpura (ITP) (70.4%). Splenectomy was applied for therapeutic purpose in 53 patients and for diagnostic purpose in 1 patient. The pathology result was Hodgkin lymphoma in the patient who receieved diagnostic splenoctomy. The most common presenting symptoms of the patients were skin lesions (petechiae, purpura, ecchymosis). Spleen size had within the normal range in 38 (70.4%) patients. Normal spleen size was observed in 35 ITP patients (92.1%) . 16 patients (29.6%) had hepatomegaly. Accessory spleen was found in 13% of patients during surgery. The most frequently reported result of splenic pathology was found to be hypersplenism. 46 patients before surgery, 16 patients after the surgery had pneumococcal and haemophilus influenza vaccines. Meningococcal vaccine could not be done because it could not be obtained. Death due to surgical complications was not observed. As a result, splenectomy, MAKALE BİLGİLERİ ÖZET

No abstract

No abstract