Document Detail

Alveolar hemorrhage as a complication of treatment with abciximab.
MedLine Citation:
PMID:  11451827     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: The use of abciximab, a chimeric monoclonal antibody Fab fragment specific for platelet glycoprotein IIb/IIIa receptors, is associated with improved outcome after angioplasty and stent placement. Major complications include bleeding, but pulmonary hemorrhage has been reported rarely. This study was done to identify patients with pulmonary hemorrhage following abciximab infusion and to define, if possible, any specific risk factors.
DESIGN: Retrospective review of institutional coronary angiography and bronchoscopy databases to identify patients who received abciximab and developed pulmonary hemorrhage.
SETTING: Tertiary-care teaching hospital.
PATIENTS: All patients who underwent coronary angiography and received abciximab between June 1995 and March 2000.
MEASUREMENTS AND RESULTS: Seven of 2,553 patients (0.27%) had documented severe pulmonary hemorrhage associated with chest radiographic abnormalities, impaired oxygenation, and the need for blood product transfusions. The initial symptom was hemoptysis in four of the seven patients. There were two early deaths and one late death. No cases of pulmonary hemorrhage were identified in 5,412 patients who underwent coronary procedures without abciximab infusion. No other risk factors predicting hemorrhage were identified.
CONCLUSIONS: Severe pulmonary hemorrhage is a complication of abciximab use. Although hemoptysis is an important alerting symptom, it may not be present initially and the diagnosis may be missed or considered late, with the potential for inappropriate treatment until the diagnosis is established. Lesser degrees of bleeding are potentially easily missed, and this report should alert physicians to this complication so that it can be considered early in the evaluation of patients presenting with pulmonary events after abciximab use.
S Kalra; M R Bell; C S Rihal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  120     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-13     Completed Date:  2001-08-09     Revised Date:  2014-07-28    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  126-31     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Angioplasty, Balloon, Coronary
Antibodies, Monoclonal / adverse effects*
Coronary Angiography
Hemorrhage / etiology*,  radiography
Immunoglobulin Fab Fragments / adverse effects*
Lung Diseases / etiology*,  radiography
Platelet Aggregation Inhibitors / adverse effects*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Radiography, Thoracic
Retrospective Studies
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; X85G7936GV/abciximab

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