Thrombotic thrombocytopenic purpura associated with ticlopidine. A review of 60 cases

• Published in: Annals of internal medicine Vol. 128; no. 7; p. 541
• Main Authors: Bennett, C L, Weinberg, P D, Rozenberg-Ben-Dror, K, Yarnold, P R, Kwaan, H C, Green, D
• Format: Journal Article
• Language: English
• Published: United States 01.04.1998
• Subjects: Adult; Aged; Cerebrovascular Disorders - prevention & control; Female; Humans; Male; Middle Aged; Plasmapheresis; Platelet Aggregation Inhibitors - adverse effects; Platelet Count; Purpura, Thrombotic Thrombocytopenic - chemically induced; Purpura, Thrombotic Thrombocytopenic - diagnosis; Purpura, Thrombotic Thrombocytopenic - therapy; Ticlopidine - adverse effects; Time Factors; Treatment Outcome
• ISSN: 0003-4819
• DOI: 10.7326/0003-4819-128-7-199804010-00004

Thrombotic thrombocytopenic purpura, a life-threatening multisystem disease, has been infrequently associated with use of ticlopidine, a platelet anti-aggregating agent. To review 60 cases of ticlopidine-associated thrombotic thrombocytopenic purpura. Medical records, published case reports, and case reports submitted to the U.S. Food and Drug Administration. Instances of ticlopidine-associated thrombotic thrombocytopenic purpura were identified. 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). 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.