Thrombotic thrombocytopenic purpura associated with ticlopidine therapy.
A patient who developed thrombotic microangiopathy while on ticlopidine therapy is reported. Thrombotic microangiopathy resolved with discontinuation of the drug and treatment with plasma exchange and has not recurred during 10 months of follow-up. The emerging data on the risk of developing thrombotic microangiopathy while on Ticlopidine and the possible mechanisms underlying this association are reviewed. The need for careful monitoring of the platelet count and hematocrit in addition to the white cell count during the first 3 months of therapy with this drug is emphasized. It is important that nephrologists, who are frequently called upon to diagnose thrombotic microangiopathy, be aware of its association with ticlopidine. Other drug-induced syndromes of thrombotic microangiography are also considered and compared, with respect to possible mechanisms of disease in each case.
Leavey
S F
SF
Department of Internal Medicine, University of Michigan Hospitals, Ann Arbor, USA.
Weinberg
J
J
D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced*; D013988:Ticlopidine / Q000009:adverse effects*
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine