AGRANULOCYTOSIS AND MACULOPAPULAR RASH AFTER TREATMENT WITH TICLOPIDINE – CASE REPORT

  • Janja Blatnik Oddelek za infekcijske bolezni in vročinska stanja Splošna bolnišnica Celje Oblakova ulica 5 3000 Celje
  • Gorazd Lešničar Oddelek za infekcijske bolezni in vročinska stanja Splošna bolnišnica Celje Oblakova ulica 5 3000 Celje
  • Branko Šibanc Oddelek za infekcijske bolezni in vročinska stanja Splošna bolnišnica Celje Oblakova ulica 5 3000 Celje
  • Stella Cvitan Oddelek za infekcijske bolezni in vročinska stanja Splošna bolnišnica Celje Oblakova ulica 5 3000 Celje
  • Harry Strokol Oddelek za sistemske in presnovne bolezni Splošna bolnišnica Celje Oblakova ulica 5 3000 Celje
Keywords: platelet aggregation inhibitor, neutropenia, agranulocytosis, thrombocytopenia, anemia

Abstract

Background. Ticlopidine is one of inhibitors of platelet aggregation indicated for reducing the risk of thrombotic stroke in patients who have experienced thrombotic stroke, ischemic attacks, unstable angina pectoris, coronary artery stenting and peripheral vascular bypass grafting. The weak point of this treatment are many serious adverse effects, the most serious of them being neutropenia.

Patient and therapy. We report a case of a 70-years old woman who developed agranulocytosis and skin rash by the end of the 4-week therapy with ticlopidine. After discontinued therapy with ticlopidine and when lenograstim was administered, agranulocytosis, anemia and rash subsided in one week.

Conclusions. As ticlopidine is associated with serious complications, its application has to be reserved for those patients who are intolerant to aspirin therapy.

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References

Carlson JA, Maesner JE. Fatal neutropenia and thrombocytopenia associated with ticlopidine. Ann Pharmacother 1994; 28: 1236–8.

Farver DK, Hansen LA. Delayed neutropenia with ticlopidine. Ann Pharmacother 1994; 28: 1344–6.

Chen DK, Kim JS, Sutton DMC. Thrombotic thrombocytopenic purpura associated with ticlopidine use. A report of 3 cases and review of the literature. Arch Intern Med 1999; 159: 311–4.

Arky R, Davidson CS. Physicians’ desk reference. 53th ed. Montvale: Medical Economics Company, 1999: 2713–6.

Kao TW, Hung CC, Chen YC, Tien HF. Ticlopidine-induced aplastic anemia: Report of three Chinese patients and review of the literature. Acta Haematol 1997; 98: 211–3.

Berrebi D, Sautet A, Flejou JF, Dauge MC, Peuchmaur M, Potet F. Ticlopidine induced colitis: a histopathological study including apoptosis. J Clin Pathol 1998; 51: 280–3.

Wegmann C, Münzenmaier R, Dormann AJ, Huchzermeyer H. Ticlopidininduzierte akute cholestatische Hepatitis. Dtsch Med Wschr 1998; 123: 146–50.

Mallet L, Mallet J. Ticlopidine and fatal aplastic anemia in an elderly woman. Ann Pharmacother 1994; 28: 1169–71.

Preložnik-Zupan I, Zupan I. Trombotična trombocitopenična purpura po tiklopidinu. Zdrav Vestn 2000; 69: 809–11.

Lesesve JF, Callat MP, Lenormand B et al. Hematological toxicity of ticlopidine. Am J Hematol 1994; 47: 149–50.

Yeh SP, Hsueh EJ, Wu H, Wang YC. Ticlopidine-associated aplastic anemia. A case report and review of literature. Ann Hematol 1998; 76: 87–90.

Haynes RB, Sandler RS, Larons EB, Pater JL, Yatsu FM. A critical appraisal of ticlopidine, a new antiplatelet agent. Arch Intern Med 1992; 152: 1376–80.

Loizon P, Nahon P, Founti H, Delecourt P, Rodor F, Jouglard J. Rupture spontanée de la rate sous Ticlopidine. A propos se deux observations. J Chir 1994; 131: 371–4.

Haas WK, Easton JD, Adams HP et al. A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high risk patients. N Engl J Med 1989; 321: 501–7.

Ono K, Kurohara K, Yoshihara M, Shimamoto Y, Yamaguchi M. Agranulocytosis caused by ticlopidine and its mechanism. Am J Hematol 1991; 37: 239–42.

Ito MK, Smith AR, Lee ML. Ticlopidine: a new platelet aggregation inhibitor. Clin Pharm 1992; 11: 603–17.

Hershey LA. Stroke prevention in women: role of aspirin versus ticlopidine. Am J Med 1991; 91: 288–92.

How to Cite
1.
Blatnik J, Lešničar G, Šibanc B, Cvitan S, Strokol H. AGRANULOCYTOSIS AND MACULOPAPULAR RASH AFTER TREATMENT WITH TICLOPIDINE – CASE REPORT. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];72(1). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1778
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