Clopidogrel-induced systemic inflammatory response syndrome.
Clopidogrel bisulfate, a widely used inhibitor of platelet aggregation, is considered at least as safe as aspirin. We describe a patient who developed a systemic inflammatory response syndrome consisting of high fever, tachycardia, cellulitis-like rash, impaired liver function, and mild leukopenia after receiving clopidogrel before coronary angiography and stent implantation. The reaction resolved promptly after withdrawal of the drug and recurred shortly after a rechallenge dose was administered, thus making the diagnosis of a clopidogrel-induced reaction highly probable. Recognition of this clopidogrel-induced syndrome is extremely important, both for rapid discontinuation of the offending drug and for avoidance of unnecessary drug therapy or invasive procedures.
Wolf
Ido
I
Department of Medicine E, Institute of Oncology, The Sheba Medical Center, Tel-Hashomer, Israel. ido.wolf@sheba.health.gov.il
Mouallem
Meir
M
Rath
Shmuel
S
Farfel
Zvi
Z
D000077144:Clopidogrel; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D015607:Stents; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000139:chemically induced*; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine