title: Thrombotic thrombocytopenic purpura associated with ticlopidine. A review of 60 cases.
abstract: 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.
authors.affiliation: Northwestern University and Chicago Veterans Affairs HealthCare System-Lakeside Division, Illinois 60611, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Bennett
authors.forename: P D
authors.initials: PD
authors.lastname: Weinberg
authors.forename: K
authors.initials: K
authors.lastname: Rozenberg-Ben-Dror
authors.forename: P R
authors.initials: PR
authors.lastname: Yarnold
authors.forename: H C
authors.initials: HC
authors.lastname: Kwaan
authors.forename: D
authors.initials: D
authors.lastname: Green
mesh_terms: 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
chemical_list: D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine