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1 April 1998 | Volume 128 Issue 7 | Pages 541-544
Background: Thrombotic thrombocytopenic purpura, a life-threatening multisystem disease, has been infrequently associated with use of ticlopidine, a platelet anti-aggregating agent.
Purpose: To review 60 cases of ticlopidine-associated thrombotic thrombocytopenic purpura.
Data Sources: Medical records, published case reports, and case reports submitted to the U.S. Food and Drug Administration.
Study Selection: Instances of ticlopidine-associated thrombotic thrombocytopenic purpura were identified.
Data Synthesis: Ticlopidine had been prescribed for less than 1 month in 80% of the patients, and normal platelet counts had been found within 2 weeks of the onset of thrombotic thrombocytopenic purpura in most patients. Mortality rates were higher among patients who were not treated with plasmapheresis than among those who underwent plasmapheresis (50% compared with 24%; P < 0.05).
Conclusions: Ticlopidine use may be associated with the development of thrombotic thrombocytopenic purpura, usually within 1 month of initiation of therapy. The onset of ticlopidine-associated thrombotic thrombocytopenic purpura is difficult to predict, despite close monitoring of platelet counts.
Author and Article Information
From Northwestern University and Chicago Veterans Affairs HealthCare System-Lakeside Division, Chicago, Illinois.
BRIEF COMMUNICATION
Thrombotic Thrombocytopenic Purpura Associated with Ticlopidine: A Review of 60 Cases
Acknowledgments: The authors thank Drs. Diane Wysowski and Janos Bacsanyi of the U.S. Food and Drug Administration for providing information on retrieval of reports and for review of the manuscript; Drs. Dave Aboulafia, Harvey Einhorn, James Grossman, Robert Hecht, Chitra Raman, Tariq Mahmood, Peter Townley, Michael Voralia, and Walter Kahr, as well as Hal Lieberman, Nurit Begani, and Dr. Josh Levy and the staff of HemaCare Corp., Sherman Oaks, California, for contributing case histories and helpful comments; Dr. James George, for helpful comments; and our index patient, for her assistance and interest.
Requests for Reprints: Charles Bennett, MD, PhD, Veterans Affairs Medical Sciences Building, #205, 400 East Ontario, Chicago, IL 60611.
Current Author Addresses: Dr. Bennett and Mr. Weinberg: Veterans Affairs Medical Sciences Building, #205, 400 East Ontario, Chicago, IL 60611.
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|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
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|
|
|
|
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|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 C. Muller, H. J. Buttner, J. Petersen, and H. Roskamm A Randomized Comparison of Clopidogrel and Aspirin Versus Ticlopidine and Aspirin After the Placement of Coronary-Artery Stents Circulation, February 15, 2000; 101(6): 590 - 593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
M. J. Quinn and D. J. Fitzgerald Ticlopidine and Clopidogrel Circulation, October 12, 1999; 100(15): 1667 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
T. J. Ryan, E. M. Antman, N. H. Brooks, R. M. Califf, L. D. Hillis, L. F. Hiratzka, E. Rapaport, B. Riegel, R. O. Russell, E. E. Smith III, et al. 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction) J. Am. Coll. Cardiol., September 1, 1999; 34(3): 890 - 911. [Full Text] [PDF]
|
|
|
|
 |
|
 {blacktriangledown}Clopidogrel and {blacktriangledown}ticlopidine - improvements on aspirin? DTB, August 1, 1999; 37(8): 59 - 61. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Elangovan Thrombotic Thrombocytopenic Purpura Associated With Ticlopidine Use Arch Intern Med, July 26, 1999; 159(14): 1624 - 1624. [Full Text] [PDF]
|
|
|
|
 |
|
 H. J M Barnett, M. Eliasziw, and H. E Meldrum Evidence based cardiology: Prevention of ischaemic stroke BMJ, June 5, 1999; 318(7197): 1539 - 1543. [Full Text]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
S. R. Steinhubl, W. A. Tan, J. M. Foody, E. J. Topol, and for the EPISTENT Investigators Incidence and Clinical Course of Thrombotic Thrombocytopenic Purpura Due to Ticlopidine Following Coronary Stenting JAMA, March 3, 1999; 281(9): 806 - 810. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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