title: Ticlopidine-induced thrombotic thrombocytopenic purpura: two case reports treated with plasma exchange plus steroids.
abstract: Thrombotic thrombocytopenic purpura (TTP) has a high mortality rate if left untreated with plasma exchange promptly. We report two cases of ticlopidine-induced TTP, which lesser dosages of ticlopidine (200-250 mg/day) were prescribed and were treated with plasma exchange (PE) plus steroids. The first case was treated successfully, but the second case did not respond to our treatment and died of a progressive disease complicated with pneumonia. In sum, we recommend careful use of ticlopidine, regardless of the dosages prescribe and regardless of how long the drug is used. Moreover, the adverse effect of ticlopidine should be closely monitored.
authors.affiliation: Hsin-Chu Hospital, Department of Health, The Executive Yuan, Taoyuan, Taiwan.
authors.forename: C W
authors.initials: CW
authors.lastname: Yang
authors.forename: Y C
authors.initials: YC
authors.lastname: Chen
authors.forename: P
authors.initials: P
authors.lastname: Dunn
authors.forename: M Y
authors.initials: MY
authors.lastname: Chang
authors.forename: J T
authors.initials: JT
authors.lastname: Fang
authors.forename: C C
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010951:Plasma Exchange; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D013988:Ticlopidine / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D010975:Platelet Aggregation Inhibitors; D003907:Dexamethasone; D013988:Ticlopidine