Clopidogrelによる無顆粒球症の1例
症例は50代,男性．急性心筋梗塞発症後にclopidogrelの投与を開始され，その5週後に無顆粒球症を発症した．同薬中止，G-CSF投与にて1週間程で回復し，狭窄冠動脈に対しては後日冠動脈バイパス術を施行された．抗血小板薬clopidogrelは，ticlopidineに替わり近年頻用されるが，無顆粒球症を始めとした血液障害を起こしうることが報告されている．稀な有害事象ながら致命的となりえるものであり，注意が必要である．...
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| Published in | 日本内科学会雑誌 Vol. 99; no. 2; pp. 337 - 339 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
2010
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.99.337 |
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| Abstract | 症例は50代,男性．急性心筋梗塞発症後にclopidogrelの投与を開始され，その5週後に無顆粒球症を発症した．同薬中止，G-CSF投与にて1週間程で回復し，狭窄冠動脈に対しては後日冠動脈バイパス術を施行された．抗血小板薬clopidogrelは，ticlopidineに替わり近年頻用されるが，無顆粒球症を始めとした血液障害を起こしうることが報告されている．稀な有害事象ながら致命的となりえるものであり，注意が必要である． |
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| AbstractList | 症例は50代,男性．急性心筋梗塞発症後にclopidogrelの投与を開始され，その5週後に無顆粒球症を発症した．同薬中止，G-CSF投与にて1週間程で回復し，狭窄冠動脈に対しては後日冠動脈バイパス術を施行された．抗血小板薬clopidogrelは，ticlopidineに替わり近年頻用されるが，無顆粒球症を始めとした血液障害を起こしうることが報告されている．稀な有害事象ながら致命的となりえるものであり，注意が必要である． |
| Author | 横山, 寿行 張替, 秀郎 山本, 譲司 武田, 守彦 伊藤, 健太 石澤, 賢一 市川, 聡 沖津, 庸子 亀岡, 淳一 |
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| References | 5) Fukushima K, et al: Incidence of side-effects of ticlopidine after sirolimus-eluting stent implantation retrospective analysis from three hospitals. Circ J 71: 617-619, 2007. 2) Nikhil JY, et al: Clopidogrel in interventional cardiology: questions answered and questions remaining. Can J Cardiol 18: 739-748, 2002. 9) Suh SY, et al: Neutropenia associated with clopidogrel use in a patient with chronic renal failure who underwent percutaneous coronary and peripheral intervention. Int J Cardiol 112: 383-385, 2006. 4) Jonas S, et al: An approach to the estimation of the risk of TTP during clopidogrel therapy. Stroke 35: 537-538, 2004. 6) Steinhubl SR, et al: Incidence and clinical course of thrombotic thrombocytopenic purpura due to ticlopidine following coronary stenting. JAMA 281: 806-810, 1999. 10) Shaefer A, et al: Severe neutropenia under clopidogrel treatment three weeks after coronary stenting. Thromb Haemost 97: 317-318, 2007. 8) Elmi F, et al: Isolated profound thrombocytopenia associated with clopidogrel. J Invasive Cardiol 12: 532-535, 2000 [Abstract] 1) Paradiso-Hardy FL, et al: Hematologic dyscrasia associated with ticlopidine therapy: evidence for causality. CMAJ 163: 1441-1448, 2000. 3) Balamuthusamy S: Hematologic adverse effects of clopidogrel. Am J Ther 14: 106-112, 2007. 7) Andres E, et al: Febrile pancytopenia associated with clopidogrel. Arch Intern Med 161: 125, 2001. |
| References_xml | – reference: 1) Paradiso-Hardy FL, et al: Hematologic dyscrasia associated with ticlopidine therapy: evidence for causality. CMAJ 163: 1441-1448, 2000. – reference: 7) Andres E, et al: Febrile pancytopenia associated with clopidogrel. Arch Intern Med 161: 125, 2001. – reference: 2) Nikhil JY, et al: Clopidogrel in interventional cardiology: questions answered and questions remaining. Can J Cardiol 18: 739-748, 2002. – reference: 8) Elmi F, et al: Isolated profound thrombocytopenia associated with clopidogrel. J Invasive Cardiol 12: 532-535, 2000 [Abstract] – reference: 9) Suh SY, et al: Neutropenia associated with clopidogrel use in a patient with chronic renal failure who underwent percutaneous coronary and peripheral intervention. Int J Cardiol 112: 383-385, 2006. – reference: 4) Jonas S, et al: An approach to the estimation of the risk of TTP during clopidogrel therapy. Stroke 35: 537-538, 2004. – reference: 6) Steinhubl SR, et al: Incidence and clinical course of thrombotic thrombocytopenic purpura due to ticlopidine following coronary stenting. JAMA 281: 806-810, 1999. – reference: 10) Shaefer A, et al: Severe neutropenia under clopidogrel treatment three weeks after coronary stenting. Thromb Haemost 97: 317-318, 2007. – reference: 3) Balamuthusamy S: Hematologic adverse effects of clopidogrel. Am J Ther 14: 106-112, 2007. – reference: 5) Fukushima K, et al: Incidence of side-effects of ticlopidine after sirolimus-eluting stent implantation retrospective analysis from three hospitals. Circ J 71: 617-619, 2007. |
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| SubjectTerms | clopidogrel ticlopidine 急性心筋梗塞 無顆粒球症 |
| Title | Clopidogrelによる無顆粒球症の1例 |
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