Contrast-induced thrombocytopenia following percutaneous coronary intervention

Ferreira, Roberto Muniz; Filho, João Mansur; Villela, Paolo Blanco; Almeida, Juliano Carvalho Gomes de; Sampaio, Pedro Paulo Nogueres; Albuquerque, Felipe N.; Pulcheri, Wolmar; Benchimol, Claudio Buarque

doi:10.1016/j.jsha.2017.01.002

Cited by 5 publications

(7 citation statements)

References 4 publications

(8 reference statements)

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“…Acute severe thrombocytopenia is an extremely rare and severe adverse complication induced by contrast media. To the best of our knowledge, 16 cases of this serious adverse reaction have been reported with different types of contrast media since the early 1980s (Table 3) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. In most patients, any symptoms, including bleeding, fever, chills, dyspnea, wheezing, abdominal pain, and blood pressure variability, were observed within 24 h after contrast administration and the platelet count was decreased to below 10,000/ μl.…”

Section: Discussionmentioning

confidence: 99%

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Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review

et al. 2020

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A 43-year-old male patient on maintenance hemodialysis had an enhanced computed tomography scan examination with iohexol for the first time 10 min before regular hemodialysis therapy. At the start of hemodialysis, no symptoms were observed, and the platelet count was 148,000/μl. Approximately 1 h after starting hemodialysis, dyspnea and chest discomfort appeared. Since oxygen saturation of the peripheral artery decreased to 87%, oxygen administration was immediately started while continuing hemodialysis therapy. Furthermore, gingival hemorrhage was observed, and the platelet count decreased to 5000/μl. We were carefully monitoring his conditions while continuing hemodialysis and oxygen administration, but no further deterioration was observed. Thereafter, these symptoms and severe thrombocytopenia gradually improved without additional treatment. At the end of hemodialysis, these symptoms completely disappeared. As well, the platelet count recovered to 35,000/μl at the end of hemodialysis and increased to 92,000/μl the next morning. From the clinical course, we diagnosed with contrast medium-induced thrombocytopenia. Acute thrombocytopenia is a rare complication induced by the contrast medium. Until now, 16 cases on contrast medium-induced thrombocytopenia have been reported. Our case spontaneously recovered from severe thrombocytopenia relatively earlier than previous reports. Our patient started hemodialysis therapy 10 min after an enhanced computed tomography examination. Early removal of contrast medium by hemodialysis might be associated with early improvement. We should acknowledge that contrast media have potential to induce severe thrombocytopenia, even in patients on maintenance hemodialysis.

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Section: Discussionmentioning

confidence: 99%

“…Eight patients received platelet transfusions [3, 5-8, 10, 12, 17]. However, five patients spontaneously recovered their platelet count in 1-9 days without any treatment [3,9,11,14,15]. For the underlying disease of patients, three patients were on maintenance hemodialysis [3,11,16] and five had renal dysfunction [3,4,6,7,10].…”

Section: Discussionmentioning

confidence: 99%

Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review

et al. 2020

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“…Ferreira RM, et al [8] 71-year-old woman underwent elective PCI to LAD. 5 hours after exposure, she developed chills, nausea, vomiting along with bleeding from the femoral access site.…”

Section: May-64mentioning

confidence: 99%

Acute Life-Threatening Contrast Induced Thrombocytopenia Following Diagnostic Coronary Angiography: A Case Report and Literature Review

DD¹,

CS²,

SV³

et al. 2021

J Clin Case Stu

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Acute severe thrombocytopenia following contrast administration is incredibly rare, but it can lead to significant morbidity. This case details the experience of a 63-year-old male whose diagnostic coronary angiography quickly led to severe thrombocytopenia with cardiovascular compromise in the absence of any immediate symptoms of anaphylaxis. His platelet count normalized within a week, increasing from 2 × 103/μL to 328 × 103/μL. A thorough review of the literature along with the present case is being reported.

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“…3 Contrast-induced thrombocytopenia is a very rare condition, with case reports being exceptional since early use during the 1980s to this day. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Iodinated contrast-induced thrombocytopenia Contrast-induced thrombocytopenia is one of the so-called drug-induced immune thrombocytopenias, which cause a decrease in platelet count (< 30 x 10 9 /L) because of destruction in peripheral blood or reduced production in the bone marrow. 19 Multiple drugs may induce this effect, including those used for chemotherapy, heparins, quinidine, tirofiban, abciximab, procainamide, protamine, and a number of monoclonal antibodies, among others.…”

Section: Introductionmentioning

confidence: 99%

Thrombocytopenia Induced by Iodinated Contrast Media: A Systematic Review

José¹,

Guillermo²,

Beatriz³

et al. 2022

MRAJ

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Iodinated contrast media are routinely used in clinical practice for diagnostic and therapeutic purposes. Adverse effects of their administration have an incidence of 3 %, and mostly consist of mild skin allergic reactions, with severe reponses such as anaphylaxis representing only 0.22 %. Contrast-induced thrombocytopenia is an extremely rare, underdiagnosed condition that most often occurs after infusion of hyperosmolar contrast agents, with low-osmolarity compounds being less likely the trigger. We report a systematic review of this condition based on the currently available series of case reports (18), as well as the clinical course of the presentation and platelet count during episodes. The physiopathogenic mechanism remains unknown, although the presence of some immune-mediated process involving changes in platelet aggregation and activation is currently accepted. Platelet response is immediate (within a few hours after exposure to the contrast agent) and consists of a fall in platelet count to < 20 x 109/L, which returns to normal at day 3 or 4. Diagnostic criteria are based on those by George and Arnold, the latter more specific for drug-induced thrombocytopenia. No routine diagnostic laboratory tests are presently available to establish a definite diagnosis, and treatment usually consists of support measures to prevent complications from occurring, but steroids, immunoglobulins, plasma exchange and/or platelet transfusions may be used. Despite its low incidence, iodinated contrast-induced thrombocytopenia is a complication to consider that may cause severe thrombocytopenia after administration of iodinated contrast agent during some diagnostic test and/or angiography.

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Contrast-induced thrombocytopenia following percutaneous coronary intervention

Cited by 5 publications

References 4 publications

Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review

Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review

Acute Life-Threatening Contrast Induced Thrombocytopenia Following Diagnostic Coronary Angiography: A Case Report and Literature Review

Thrombocytopenia Induced by Iodinated Contrast Media: A Systematic Review

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