title: Ticlopidine induced prolonged leucopenia in a patient with immunocytoma and chronic hepatitis C.
abstract: Ticlopidine is increasingly used in the secondary prophylaxis in patients with arterial occlusive diseases. Neutropenia is a well known side effect of this drug. We report a case of a 73 year old woman who was admitted because of severe prolonged ticlopidine induced leucopenia. The past medical history included an immunocytoma of the IgM-kappa type diagnosed seven years ago with less than 10% infiltration of the bone marrow and a chronic hepatitis C. On admission the white cell count was 1000/microL. Ticlopidine was stopped. The white cell count did not increase within one week, thus filgastrim was applied on two consecutive days. The leucocyte count promptly increased to 6000/microL but consecutively dropped within the next fortnight again to levels below 500/microL forcing daily filgastrim application for another 9 days. Four months after the initiation of the therapy with filgastrim the patient had a white cell count of 4300/microL. We therefore conclude that in patients with a history of potentially bone marrow suppressing diseases the use of ticlopidine has to be carefully weighed against possible myelosuppressive effects.
authors.affiliation: Department of Medical Angiology, Vienna General Hospital, University of Vienna Medical School, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Redlich
authors.forename: B
authors.initials: B
authors.lastname: Parschalk
authors.forename: H
authors.initials: H
authors.lastname: Ehringer
authors.forename: E
authors.initials: E
authors.lastname: Minar
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000276:immunology; D001853:Bone Marrow / Q000187:drug effects / Q000276:immunology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000276:immunology; D007970:Leukopenia / Q000139:chemically induced*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012008:Recurrence; D012307:Risk Factors; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine