Prolonged profound abciximab associated immune thrombocytopenia complicated by transient multispecific platelet antibodies

Patients receiving abciximab occasionally develop transient severe thrombocytopenia within a few hours of receiving the drug. Thrombocytopenia has been reported to resolve within 10 days of abciximab administration, but in this case profound thrombocytopenia lasted 21 days before a slow spontaneous recovery. Management was complicated by the presence of HLA antibodies and the transient production of antibodies directed at major platelet glycoproteins IIb/IIIa, Ib/IX, and Ia/IIa. The patient remained refractory to platelet transfusion and two courses of intravenous gammaglobulin for the duration of her admission.