title: Ticagrelor induced systemic inflammatory response syndrome.
abstract: Ticagrelor is a reversible and direct-acting oral antagonist of the adenosine diphosphate receptor P2Y12. Possible adenosine-mediated effects of ticagrelor on inflammation are complex and incompletely understood. To our knowledge, ticagrelor-induced systemic inflammatory response syndrome (SIRS) has not yet been described.
  
  
  
  We report the case of an 84 years old patient presenting with SIRS subsequent to initiation of ticagrelor after implantation of two drug eluting stents. A broad diagnostic work-up for alternative causes and therapeutic measures were unrevealing. Discontinuation of the agent was followed by rapid improvement in clinical and laboratory signs of SIRS.
  
  
  
  After exclusion of other causes, ticagrelor needs to be considered as a possible causative agent for SIRS. Due to the widespread use of ticagrelor, clinicians should be aware of this possible adverse drug reaction.
authors.affiliation: Department of Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. philipp.krisai@usb.ch.|Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. philipp.krisai@usb.ch.
authors.forename: Philipp
authors.initials: P
authors.lastname: Krisai
authors.affiliation: Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Haschke
authors.affiliation: Department of Cardiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Buser
authors.affiliation: Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.|Department of Cardiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000241:Adenosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000284:Administration, Oral; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D018746:Systemic Inflammatory Response Syndrome / Q000139:chemically induced*; D000077486:Ticagrelor
chemical_list: D058921:Purinergic P2Y Receptor Antagonists; D000077486:Ticagrelor; D000241:Adenosine
keywords: Adverse drug reaction; Case report; SIRS; Ticagrelor