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Clopidogrel-associated leukopenia.

Michelle W McCarthy1, Denise R Kockler

  • 1Department of Pharmacy Services, University of Virginia Health System, Charlottesville, VA 22908-0674, USA. mm4tm@virginia.edu

The Annals of Pharmacotherapy
|January 29, 2003
PubMed
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Clopidogrel, an antiplatelet medication, can rarely cause leukopenia, a condition of low white blood cell count. This case highlights a potential adverse effect requiring clinical awareness in patients undergoing stent placement.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Clopidogrel is a widely used thienopyridine antiplatelet agent, often prescribed after intracoronary stent placement.
  • It has largely replaced ticlopidine due to better tolerability and reduced toxicity.
  • Myelotoxicity is a known, albeit rare, adverse effect associated with thienopyridine therapy.

Observation:

  • A 58-year-old male developed fever and chills post-intracoronary stent placement.
  • Laboratory tests revealed leukopenia (low white blood cell count) with negative infectious workups.
  • Discontinuation of clopidogrel led to the resolution of leukopenia within seven days.

Findings:

  • The patient's leukopenia was determined to be a probable adverse reaction to clopidogrel.

Related Experiment Videos

  • This case adds to the limited reports of clopidogrel-associated white blood cell toxicity.
  • The mechanism underlying clopidogrel-induced myelotoxicity remains unclear.

    • Implications:

    • Clinicians should maintain awareness of the potential for rare hematologic adverse effects like leukopenia with clopidogrel.
    • While infrequent, this adverse event can occur weeks to months after initiating therapy.
    • Prompt recognition and discontinuation of the drug can lead to recovery.