A Case Report of Ticagrelor-Induced Thrombocytopenia

INTRODUCTION: We report a case of new-onset thrombocytopenia following administration of a loading dose of ticagrelor. CASE PRESENTATION: A 66-year-old male known to have diabetes mellitus type II, chronic obstructive airway disease, and hypertension presented to the emergency department with retrosternal chest pain and dyspnea. Work-up on presentation showed Hb 14.7 g/dL, platelet 229 × 10(9)/L, and troponin 309 ng/mL. The electrocardiogram showed ST elevation in the anterior-lateral leads. The patient underwent balloon angioplasty, and a drug-eluting stent was deployed. During the procedure, intravenous unfractionated heparin and a 180 mg loading dose of ticagrelor were given. Six hours post procedure, the platelet count was 70 × 10(9)/L without active bleeding. Blood smear was unremarkable, and no schistocytes could be seen. So, ticagrelor was stopped, and the patient’s platelet count completely recovered four days after discontinuation. CONCLUSION: Ticagrelor-induced thrombocytopenia is a rare but increasingly recognized entity. Therefore, post-treatment monitoring and early recognition are crucial parts of management.