TICLOPIDINE AND FATAL APLASTIC-ANEMIA IN AN ELDERLY WOMAN

OBJECTIVE: To report a case of aplastic anemia that developed during t iclopidine treatment. CASE SUMMARY: An 84-year-old woman was started o n ticlopidine for secondary stroke prevention. Within six weeks of ini tiating ticlopidine therapy she developed aplastic anemia. She was hos pitalized and received empiric antibiotics, antifungal agents, blood t ransfusions, platelets, and granulocyte colony-stimulating factor. The patient died on day 76 after beginning ticlopidine. DISCUSSION: Hemat ologic effects such as neutropenia, thrombocytopenia, agranulocytosis, thrombotic thrombocytopenic purpura, and pancytopenia have been descr ibed with the use of ticlopidine. Previous case reports have associate d ticlopidine with the development of aplastic anemia. CONCLUSIONS: Ti clopidine can produce fatal hematologic adverse effects, and its use s hould be reserved as second-line therapy.