Tirofiban-Associated Profound Thrombocytopenia in a Patient With Glucose-6-Phosphate Dehydrogenase Deficiency Undergoing Primary Percutaneous Coronary Intervention: A Case Report.

Background: Profound thrombocytopenia after tirofiban exposure during primary percutaneous coronary intervention (PCI) is rare but clinically important. Causal attribution may be challenging when unfractionated heparin is coadministered, and the relevance of glucose-6-phosphate dehydrogenase (G6PD) deficiency remains uncertain. Case Presentation: A 34-year-old man with known G6PD deficiency presented with an inferior ST-segment elevation myocardial infarction and underwent primary PCI. He received aspirin, ticagrelor, and unfractionated heparin. Coronary angiography showed multivessel coronary disease with complete occlusion of the mid-to-distal right coronary artery and a large thrombus burden. After aspiration thrombectomy and drug-eluting stent implantation, intracoronary tirofiban (2500 Interventions and Outcomes: Tirofiban and heparin were discontinued immediately, and intravenous immunoglobulin (20 g/day) was administered. The platelet count recovered to 25 × 10 Conclusions: This case supports tirofiban-associated acute profound thrombocytopenia as the most likely diagnosis and underscores the importance of prompt drug withdrawal, structured differential diagnosis against heparin-induced thrombocytopenia, and individualized antithrombotic reinitiation. The contribution of G6PD deficiency remains hypothetical and requires further study.