[Clopidogrel induced thrombotic thrombocytopenic purpura]

Rev Med Interne. 2011 Dec;32(12):762-5. doi: 10.1016/j.revmed.2011.10.004. Epub 2011 Nov 16.
[Article in French]

Abstract

Introduction: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder. Drug-induced TTP is uncommon and we report a TTP associated with the use of clopidogrel.

Case report: We report a 50-year-old man who presented with acute myocardial infarction and received clopidogrel therapy. He developed acute TTP ten days after clopidogrel onset. Imputability of the drug was demonstrated during a reintroduction test. Deficiency of ADAMTS 13 was confirmed and autoantibodies against ADAMTS 13 were detected. Complete remission was obtained after 24 plasma exchange sessions and adjunction of corticosteroids.

Conclusion: Drug-induced TTP are probably immunologic, as was demonstrated in our patient. Clinicians should be aware of this possible uncommon adverse effect of clopidogrel because prompt therapy is imperative for life saving.

Publication types

  • Case Reports

MeSH terms

  • Clopidogrel
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use
  • Purpura, Thrombotic Thrombocytopenic / chemically induced*
  • Purpura, Thrombotic Thrombocytopenic / diagnosis*
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine

Supplementary concepts

  • Thrombotic thrombocytopenic purpura, acquired