One Case of Thrombotic Thrombocytopenic Purpura Caused by Tirofiban Hydrochloride and Sodium Chloride Injection

doi:10.19803/j.1672-8629.20250297

Abstract

Abstract: Objective To investigate one case of tirofiban-induced thrombotic thrombocytopenic purpura (TTP) so as to provide a reference for safe medication. Methods One case of tirofiban-induced TTP was analyzed in terms of clinical manifestations, mechanisms and treatment strategies based on literature. Results Six days into tirofiban administration, the patient developed severe thrombocytopenia, bleeding, limb weakness, slowed response and microangiopathic hemolytic anemia (MAHA). In combination with bone marrow aspiration findings, these symptoms pointed to tirofiban-induced TTP. Platelet counts returned to normal eight days after drug discontinuation and symptomatic treatment. Conclusion Tirofiban may induce the risk of TTP. Platelet counts should be closely monitored when tirofiban is administered. Once TTP is suspected, the risk should be assessed or the activity of ADAMTS13 is tested for early identification and management.

Key words: Tirofiban, Thrombotic Thrombocytopenic Purpura, Microangiopathic Hemolytic Anemia(MAHA), Adverse Drug Reaction

CLC Number:

R972
R994.11

CAO Yang, FU Xiaoxiu, MA Lin. One Case of Thrombotic Thrombocytopenic Purpura Caused by Tirofiban Hydrochloride and Sodium Chloride Injection[J]. Chinese Journal of Pharmacovigilance, 2026, 23(3): 346-348.

Add to citation manager EndNote|Ris|BibTeX

URL: https://zgywjj.magtechjournal.com/EN/10.19803/j.1672-8629.20250297

https://zgywjj.magtechjournal.com/EN/Y2026/V23/I3/346

References

[1] China Stroke Society, Branch of Neurointervention of China Stroke Society, Interventional Group of Stroke Prevention and Control Committee of Chinese Preventive Medicine Association. Expert Consensus on the Clinical Application of Tirofiban in Atherosclerotic Cerebrovascular Diseases[J]. China Journal of Stroke(中国卒中杂志), 2019, 14(10): 1034-1044.
[2] JEONG HG, KIM BJ, YANG MH, et al.Stroke Outcomes with Use of Antithrombotics within 24 Hours after Recanalization Treatment[J]. Neurology, 2016, 87(10): 996-1002
[3] LI W, LIN L, ZHANG M, et al.Safety and Preliminary Efficacy of Early Tirofiban Treatment after Alteplase in Acuteischemic Stroke Patients[J]. Stroke, 2016, 47(10): 2649-2651.
[4] WU C, SUN C, WANG L, et al.Low-Dose Tirofiban Treatment Improves Neurological Deterioration Outcome after Intravenous Thrombolysis[J]. Stroke, 2019, 50(12): 3481-3487.
[5] CHEN ZY, YAN XX.Analysis of Tirofiban-Induced Thrombocytopenia[J]. Chinese Journal of Arteriosclerosis(中国动脉硬化杂志), 2022, 30(7): 633-639.
[6] Chinese Society of Neurology, Chinese Society of Stroke. Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2023[J]. Chinese Journal of Neurology(中华神经科杂志), 2024, 57(6): 523-559
[7] SUN MX, YUAN YF.Analysis of 123 Adverse Drug Reactions Induced by Tirofiban[J]. Journal of Ningxia Medical University(宁夏医科大学报), 2022, 44(12): 1267-1271.
[8] TANG Y, XU S, HUANG CL,et al.Tirofiban-Induced Severe Throm-bocytopenia after Basilar Artery Stenting[J]. Chinese Journal of Clinical Neurosurgery(中国临床神经外科杂志), 2023, 28(4): 285.
[9] WANG L, ZHANG LP, REN YJ, et al.Clinical Analysis of Tirofiban-Induced Severe Thrombocytopenia: a Case Report[J]. Adverse Drug Reactions Journal(药物不良反应杂志), 2022, 24(9): 471-477.
[10] ZHAO XZ, CUI HG.Typing of Drug-Induced Immune Thrombocytopenia and Research Progress in Diagnosis and Treatment of Tirofiban-Induced Thrombocytopenia[J]. Shandong Medical Journal(山东医药), 2022, 62(33): 102-106.
[11] NMPA. Guideline for Collection and Reporting of Individual Adverse Drug Reactions[EB/OL]. (2018-12-21)[2024-02-22]. https://www.nmpa.gov.cn/xxgk/ggtg/ypggtg/ypqtggtg/20181221172901438.html.
[12] Thrombosis and Hemostasis Group, Chinese Society of Hematology, Chinese Medical Association. Chinese Guideline for the Diagnosis and Management of Thrombotic Thrombocytopenic Purpura (2022)[J]. Chinese Journal of Hematology(中华血液学杂志), 2022, 43(1): 7-12.
[13] PAGE EE, KREMER HOVINGA JA, TERRELL DR, et al.Thrombotic Thrombocytopenic Purpura: Diagnostic Criteria, Clinical Features, and Long-Term Outcomes from 1995 through 2015[J]. Blood Adv, 2017, 1(10): 590-600.
[14] JOLY BS, COPPO P, VEYRADIER A.Thrombotic Thrombocytopenic Purpura[J]. Blood, 2017, 129(21): 2836-2846.
[15] BENDAPUDI PK, HURWITZ S, FRY A, et al.Derivation and External Validation of the PLASMIC Score for Rapid Assessment of Adults with Thrombotic Microangiopathies: a Cohort Study[J]. Lancet Haematol, 2017, 4(4): e157-e164.
[16] MASANORI M, YOSHITAKA M, KOICHI K, et al.Diagnostic and Treatment Guidelines for Thrombotic Thrombocytopenic Purpura (TTP) in Japan 2023[J]. International Journal of Hematolog, 2023, 118(5): 529-546.
[17] LI XR, WANG FM, ZHANG XL, et al.Clinical Features and Treatment Outcomes of 24 Adult Patients with Thrombotic Thrombocytopenic Purpura[J]. Chinese Journal of Nephrology(中华肾脏病杂志), 2025, 41(8): 579-586.
[18] SAID SM, HAHN J, SCHELEYER E, et al.GlycoproteinⅡb/Ⅲa Inhibitor Induced Thrombocytopenia: Diagnosis and Treatment[J]. Clin Res Cardiol, 2007, 96(2): 61-69.