title: Case report: use of thienopyridines in a patient with acquired idiopathic thrombotic thrombocytopenic purpura.
abstract: Thienopyridines are commonly used anti-platelet drugs that may be associated with the development of secondary, drug-induced thrombotic thrombocytopenic purpura (TTP), a rare but potentially life threatening condition. We report the case of a 70 year-old man with a history of recurrent idiopathic TTP episodes who was treated with clopidogrel and then ticlopidine for thromboprophylaxis after percutaneous coronary intervention. Treatment was successful with no signs of TTP recurrence. Platelet counts and ADAMTS13 activity levels remained normal for months after the initiation of anti-platelet therapy, with no reappearance of anti-ADAMTS13 autoantibodies. This report demonstrates that thienopyridines do not necessarily induce TTP in patients with a history of TTP who are in disease remission.
authors.forename: Luca A
authors.initials: LA
authors.lastname: Lotta
authors.forename: Ilaria
authors.initials: I
authors.lastname: Mancini
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tuana
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Musallam
authors.forename: Flora
authors.initials: F
authors.lastname: Peyvandi
mesh_terms: D051722:ADAM Proteins / Q000097:blood; D000071120:ADAMTS13 Protein; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D000077144:Clopidogrel; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000188:drug therapy*; D013988:Ticlopidine / Q000008:administration & dosage* / Q000031:analogs & derivatives*
chemical_list: D001323:Autoantibodies; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human; D013988:Ticlopidine