Diffuse Alveolar Hemorrhage Secondary to Abciximab—a Case Report

Abstract

Diffuse alveolar hemorrhage (DAH) is unusual and can be a life-threatening side effect of glycoprotein IIb/IIIa receptor antagonists like abciximab. Early diagnosis of this condition can play a key role in preventing adverse outcomes. We report a case of a 74-year-old female who suffered from acute lateral wall myocardial infraction and was treated with a coronary angioplasty. She received abciximab infusion during and after coronary angioplasty due to a high thrombus burden. After the procedure, she had worsening respiratory distress with hemoptysis, and on detailed evaluation, DAH secondary to abciximab was diagnosed. The diagnosis of DAH post-myocardial infraction and coronary angioplasty can be challenging as clinically, it can mimic conditions like acute left ventricular failure and pulmonary embolism. A high index of suspicion is required to diagnose DAH secondary to glycoprotein IIb/IIIa receptor antagonist. The treatment is essentially supportive with immediate cessation of the culprit drug and other anticoagulants. Few cases of severe DAH that are refractory to supportive management might benefit from steroids.