Thrombotic thrombocytopenic purpura associated with ticlopidine. A review of 60 cases.
BACKGROUND
Thrombotic thrombocytopenic purpura, a life-threatening multisystem disease, has been infrequently associated with use of ticlopidine, a platelet anti-aggregating agent.


OBJECTIVE
To review 60 cases of ticlopidine-associated thrombotic thrombocytopenic purpura.


METHODS
Medical records, published case reports, and case reports submitted to the U.S. Food and Drug Administration.


METHODS
Instances of ticlopidine-associated thrombotic thrombocytopenic purpura were identified.


RESULTS
Ticlopidine had been prescribed for less than 1 month in 80% of the patients, and normal platelet counts had been found within 2 weeks of the onset of thrombotic thrombocytopenic purpura in most patients. Mortality rates were higher among patients who were not treated with plasmapheresis than among those who underwent plasmapheresis (50% compared with 24%; P < 0.05).


CONCLUSIONS
Ticlopidine use may be associated with the development of thrombotic thrombocytopenic purpura, usually within 1 month of initiation of therapy. The onset of ticlopidine-associated thrombotic thrombocytopenic purpura is difficult to predict, despite close monitoring of platelet counts.
Bennett
C L
CL
Northwestern University and Chicago Veterans Affairs HealthCare System-Lakeside Division, Illinois 60611, USA.
Weinberg
P D
PD
Rozenberg-Ben-Dror
K
K
Yarnold
P R
PR
Kwaan
H C
HC
Green
D
D
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D010976:Platelet Count; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D013988:Ticlopidine / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine