Letter to the Editor Alveolar Hemorrhage during Abciximab Infusion

Alveolar hemorrhage following the administration of a glycoprotein IIb/IIIa receptor antagonist is an extremely rare and catastrophic complication. Only a few such cases have been reported in the literature thus far. We present a case of acute myocardial infarction complicated by diffuse alveolar hemorrhage. A 57-year-old man was admitted to our hospital with a diagnosis of anterior ST-elevation myocardial infarction. A loading dose of aspirin (300 mg) and ticagrelor (180 mg) was given, and emergency coronary angiography was performed. After a bolus dose of unfractionated heparin (60 units/kg) was given, the occluded proximal left coronary artery was reopened by percutaneous coronary intervention with a drug-eluting stent. Due to the high thrombus burden, a bolus dose of abciximab (0.75 mg/kg) was given, and infusion via a vein pathway was scheduled for 12 hours. The patient complained of respiratory distress with hemoptysis 3 hours after the abciximab infusion. The hemoglobin level was found to be 11 g/dL, and there was no thrombocytopenia. The chest X-ray revealed bilateral pulmonary opacities (Figure 1). The abciximab infusion was then stopped, and a chest computed tomography was performed, which illustrated a sign of alveolar hemorrhage (Figure 2). The dual antiplatelet therapy (aspirin/ticagrelor) was continued.....