Thrombotic thrombocytopenic purpura associated with clopidogrel administration: Case report and brief review

Clopidogrel has replaced ticlopidine (in the United States but not worldwid e). Clopidogrel can either be used independently or in combination with oth er antiplatelet agents. Clopidogrel has a lower frequency of associated thr ombotic thrombocytopenic purpura than ticlopidine, a lower rate of neutrope nia, and better gastrointestinal tolerance. We describe a case of thromboti c thrombocytopenic purpura associated with the use of clopidogrel after per cutaneous transluminal angioplasty and stent placement. Discontinuation of the drug and transfusion of 17 units of cryodepleted plasma resulted in res olution of the hematological abnormalities. Clinicians should be alert to t his adverse effect of clopidogrel and monitor platelet counts in patients r eceiving it.