title: Clopidogrel-induced Thrombotic Microangiopathy in a Patient with Hypocomplementemia.
abstract: Clopidogrel was administered to a 67-year-old Japanese man to prevent the recurrence of cerebral infarction. Twelve weeks later, he was admitted to our hospital with acute renal failure, hemolytic anemia and thrombocytopenia, and was diagnosed with clopidogrel-induced thrombotic microangiopathy. Clopidogrel was immediately discontinued and corticosteroid and plasma exchange therapy were administered simultaneously. Thereafter, the patient's condition gradually improved. The patient had a decreased serum complement C3 level. This suggests that the activated alternative pathway is related to thrombotic microangiopathy (TMA). TMA is a critical drug-associated adverse reaction that clinicians should always be vigilant about, because clopidogrel is widely prescribed.
authors.affiliation: Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tada
authors.forename: Kenji
authors.initials: K
authors.lastname: Ito
authors.forename: Aki
authors.initials: A
authors.lastname: Hamauchi
authors.forename: Koji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Renya
authors.initials: R
authors.lastname: Watanabe
authors.forename: Ai
authors.initials: A
authors.lastname: Uchida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Abe
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Yasuno
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Miyake
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Sasatomi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakashima
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D000743:Anemia, Hemolytic / Q000150:complications / Q000628:therapy; D002544:Cerebral Infarction / Q000517:prevention & control; D000077144:Clopidogrel; D006801:Humans; D008297:Male; D010951:Plasma Exchange; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D057049:Thrombotic Microangiopathies / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000305:Adrenal Cortex Hormones; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine